Key result
CMR characterizes non-enhancing aortic valve vegetation as NBTE and reveals underlying metastatic urothelial carcinoma.
Why the study?
The diagnostic challenges and management considerations of nonbacterial thrombotic endocarditis secondary to malignancy require further clinical characterization.
Case Report (n=1)
This case highlights the diagnostic utility of cardiac magnetic resonance imaging in characterizing valvular lesions like nonbacterial thrombotic endocarditis and emphasizes the need for malignancy screening in these patients.
A 72-year-old male with a medical history significant for ischemic cardiomyopathy, prostate cancer, and peripheral vascular disease presented with jaundice, progressive frailty, and anemia. Transthoracic echocardiography identified a new aortic valve vegetation. Comprehensive infectious evaluation yielded negative results, and cardiac magnetic resonance (CMR) imaging demonstrated a non-enhancing lesion involving the aortic valve. Given the negative infectious evaluation and absence of systemic signs of infection, a diagnosis of nonbacterial thrombotic endocarditis (NBTE) was favored. Concurrent imaging revealed pancreatic involvement by metastatic urothelial carcinoma. Anticoagulation therapy was initiated but subsequently discontinued due to the development of symptomatic anemia and thrombocytopenia. This case underscores the diagnostic utility of CMR in characterizing valvular lesions and emphasizes the importance of malignancy screening in patients with suspected NBTE. A multidisciplinary approach enabled the formulation of a patient-centered management strategy within the context of advanced malignancy.
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Rodriguez et al. (2025) conducted a case report in Nonbacterial thrombotic endocarditis (NBTE) (n=1). Cardiac magnetic resonance (CMR) was evaluated on Characterization of valvular lesion. Cardiac magnetic resonance imaging successfully characterized a non-enhancing aortic valve vegetation as nonbacterial thrombotic endocarditis, revealing underlying metastatic urothelial carcinoma.
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