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Rapid Embolic Event Chain: An Unusual Presentation of Marantic Endocarditis
Camron Costa1, Fazal Dalal1, Olajide Buhari2
1Internal Medicine, Baylor Scott & White Medical Center - Temple, Temple, USA.
Cureus
|June 9, 2025
Summary
Nonbacterial thrombotic endocarditis (NBTE) involves sterile vegetations linked to cancer, causing severe embolic events. Early NBTE recognition and intervention are crucial to prevent life-threatening complications like stroke and limb ischemia.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Nonbacterial thrombotic endocarditis (NBTE), previously marantic endocarditis, is characterized by sterile vegetations.
- NBTE is strongly associated with hypercoagulable states, particularly advanced malignancies.
Observation:
- A case of NBTE presented with a rapid cascade of embolic events in a patient with newly diagnosed metastatic lung cancer.
- The patient experienced critical limb ischemia necessitating bilateral below-knee amputation.
- Echocardiography confirmed mitral valve vegetations.
Findings:
- Post-amputation, the patient suffered an acute stroke and acute coronary syndrome.
- These embolic events ultimately led to the patient's death.
Implications:
- This case highlights the severe thromboembolic risks associated with NBTE.
- Emphasizes the critical need for prompt diagnosis and management of NBTE, especially in cancer patients.
- Early intervention is vital to mitigate potentially fatal embolic complications.
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