Non-bacterial thrombotic endocarditis masquerading as infective endocarditis: a paraneoplastic process
Ujjawal Kumar1,2, Daniel Sitaranjan2, Sambhavi Sneha Kumar1
1School of Clinical Medicine, University of Cambridge, Hills Road, Cambridge, CB2 0SP, United Kingdom.
Journal of Surgical Case Reports
|April 16, 2025
Summary
A patient suspected of infective endocarditis was found to have metastatic adenocarcinoma. This case underscores the importance of considering paraneoplastic processes in atypical endocarditis presentations.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Infective endocarditis is a serious infection of the heart valves.
- Systemic emboli are a common complication of infective endocarditis.
Observation:
- A 76-year-old female presented with symptoms suggestive of infective endocarditis.
- Imaging revealed cardiac masses, septic emboli, and lesions in the lungs, liver, and brain.
- Initial antibiotic treatment failed, necessitating emergency cardiac surgery.
Findings:
- Post-surgery, the patient developed extensive thrombosis on the prosthetic valve and elsewhere.
- Hepatic biopsy confirmed metastatic adenocarcinoma, with autopsy revealing pulmonary adenocarcinoma with widespread metastases.
- The patient's condition deteriorated, leading to a fatal outcome.
Implications:
- This case highlights the critical need to consider paraneoplastic syndromes in patients presenting with atypical features of infective endocarditis.
- Early recognition of underlying malignancy can potentially alter patient management and outcomes.
- Multidisciplinary collaboration between cardiology, oncology, and pathology is crucial for diagnosing and managing complex cases.
Keywords:
metastatic adenocarcinomamitral valve replacementnon-bacterial thrombotic endocarditisseptic embolithrombotic neoplastic syndromeMore Related Videos
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