Key result
Multi-valvular NBTE causes sequential PE, MI, and stroke in lung adenocarcinoma.
Why the study?
Non-bacterial thrombotic endocarditis is an uncommon condition with complex diagnosis and infrequent reports of coronary embolism causing myocardial infarction.
Case Report (n=1)
Non-bacterial thrombotic endocarditis is a rare cause of sequential pulmonary embolism, myocardial infarction, and stroke, requiring a high index of suspicion and management with anticoagulation and treatment of the underlying cause.
Non-bacterial thrombotic endocarditis is an uncommon entity that tends to be related to malignancy or rheumatological disorders. The diagnosis is complex and requires a high index of suspicion. It commonly causes recurrent emboli; however, coronary embolism remains an infrequently reported entity. Herein we report a unique case of sequential pulmonary embolism, ST-elevation myocardial infarction (MI), and stroke associated with multi-valvular non-bacterial thrombotic endocarditis. The cornerstone of management is treating the underlying cause and anticoagulation therapy. Surgical treatment should be considered in patients with acute heart failure secondary to valvular dysfunction and recurrent thromboembolism despite proper anticoagulation. We have performed an extensive literature search and found nine cases of established antemortem diagnosis of myocardial infarction secondary to non-bacterial thrombotic endocarditis, and we reviewed them according to cause, treatment, and outcome.
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Karameh et al. (2022) conducted a case report in Non-bacterial thrombotic endocarditis (n=1). Percutaneous coronary intervention and medical therapy was evaluated. A 47-year-old woman with lung adenocarcinoma developed multi-valvular non-bacterial thrombotic endocarditis leading to sequential pulmonary embolism, acute myocardial infarction, and stroke.
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