Non-bacterial thrombotic endocarditis (NBTE) is a form of non-infective endocarditis characterized by the deposition of sterile fibrin and platelets on cardiac valves. Even though some studies have identified important pathophysiological features, many aspects remain poorly understood. Given its wide availability, transthoracic echocardiography is typically the initial diagnostic approach to the patient. Additionally, recent technological advancements in transesophageal echocardiography, such as three-dimensional and multiplanar reconstruction analysis, have significantly improved diagnostic accuracy over time. By presenting our case series and performing a literature review, we focused on the main pathophysiologic, diagnostic, and therapeutic aspects of this rare but potentially life-threatening disease.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11355671PMC
http://dx.doi.org/10.3390/jcm13164904DOI Listing

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Non-bacterial thrombotic endocarditis (NBTE) causes myocardial and cerebral infarctions and is associated with advanced stages of malignancy. However, only a few cases of myocardial and cerebral infarctions have been reported in the same patient. We herein report a 47-year-old woman with advanced uterine and ovarian cancer who experienced acute myocardial infarction (MI) after receiving chemotherapeutic intervention for the cancer and hemorrhagic cerebral infarction 1 month after admission for acute MI, attributable to NBTE of the aortic valve.

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Background: Very limited data indicate that patients with stroke from cancer-associated NBTE (Ca-NBTE) exhibit a characteristic pattern of widely distributed ischemic lesions of varying sizes.

Methods: An electronic search of Mayo Clinic records (03/31/2002-06/30/2022) with ensuing manual review of brain magnetic resonance imaging (MRI) was performed to identify topographic characteristics of stroke from Ca-NBTE.

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Non-bacterial thrombotic endocarditis: a clinical and pathophysiological reappraisal.

Eur Heart J

November 2024

Department of Cardiology, University of Texas Health Sciences Center, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.

Non-bacterial thrombotic endocarditis (NBTE), formerly recognized as marantic endocarditis, represents a rare cardiovascular pathology intricately linked with hypercoagulable states, notably malignancy and autoimmune disorders. Characterized by the development of sterile vegetations comprised of fibrin and platelets on cardiac valves, NBTE poses a diagnostic challenge due to its resemblance to infective endocarditis. Therapeutic endeavours primarily revolve around addressing the underlying aetiology and instituting anticoagulant regimens to forestall embolic events, with surgical intervention seldom warranted.

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Non-bacterial thrombotic endocarditis is a rare condition characterized by the formation of thrombotic vegetations on heart valve leaflets, leading to valvular dysfunction, heart failure and thromboembolic events. It is known to be associated with other diseases and some cases remain undiagnosed or can be diagnosed in the postmortem analysis. Surgical excision of the mass may be necessary to prevent further embolic events and other complications.

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