Strokes and Diagnostic Dilemmas: Non-bacterial Thrombotic Endocarditis Mimicking a Flail Mitral Valve

Non-bacterial thrombotic endocarditis (NBTE) is a rare condition characterized by sterile vegetations on cardiac valves, commonly associated with malignancy or autoimmune disorders. These vegetations pose a significant risk of embolization, leading to adverse complications such as ischemic stroke. We present a case of a 60-year-old female initially suspected of having a brain tumor, later diagnosed with multifocal strokes due to NBTE. Initial interpretation of a flail mitral valve was subsequently revised to NBTE on further assessment, but this resulted in a delay of anticoagulation initiation. This case highlights the importance of early recognition and multidisciplinary management of NBTE to prevent recurrent embolic events, highlighting the diagnostic challenges and the role of anticoagulation in its treatment.