Key result
Coronary thrombectomy was successfully performed for thrombotic occlusion due to non-bacterial thrombotic endocarditis in a patient with metastatic small cell lung carcinoma, but the patient died.
Case Report (n=1)
This case highlights the rare but severe complication of non-bacterial thrombotic endocarditis leading to coronary embolisation and myocardial infarction in a patient with metastatic small cell lung carcinoma.
Procedural success in NBTE-related coronary occlusion does not ensure survival in metastatic cancer; leaves open optimal management strategies.
A 66-year-old Caucasian man was initially admitted with a metastatic small cell lung carcinoma, hyponatraemia and obstructive pneumonia. His transthoracic echocardiogram (TTE) was normal. Ten days after admission, he was diagnosed with a non-ST segment elevation myocardial infarction (MI). Both a repeated TTE and a transoesophageal echocardiogram identified thickened, myxomatous mitral valve leaflet tips with small, mobile masses identified as vegetations, and new, eccentric, severe mitral regurgitation. Subsequent cardiac catheterisation recorded thrombotic occlusion of the right coronary artery. Successful coronary thrombectomy was carried out, but the patient died. A diagnosis of non-bacterial thrombotic endocarditis leading to coronary embolisation and MI was made. The clinical course and treatment choices are discussed.
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Gray et al. (2021) conducted a case report in Non-bacterial thrombotic endocarditis and metastatic small cell lung carcinoma (n=1). Coronary thrombectomy was evaluated. Coronary thrombectomy was successfully performed for thrombotic occlusion due to non-bacterial thrombotic endocarditis in a patient with metastatic small cell lung carcinoma, but the patient died.
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