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Nonbacterial thrombotic endocarditis (NBTE) is a pathologic state associated with autoimmune diseases and malignancy in which platelet thrombi are deposited on the heart valves in the absence of a bloodstream infection. NBTE is a diagnosis of exclusion that requires a high degree of clinical suspicion after infective endocarditis etiologies have been ruled out. The treatment of NBTE consists of systemic anticoagulation, with direct oral anticoagulants and surgery not having a clear role. The following case reviews a patient's journey to the diagnosis of tricuspid valve nonbacterial thrombotic endocarditis in the setting of recently diagnosed metastatic lung cancer. This case adds to the growing literature on the diagnostic approach to NBTE.
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http://dx.doi.org/10.56305/001c.57553 | DOI Listing |
ARYA Atheroscler
January 2025
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Nonbacterial thrombotic endocarditis (NBTE) is a rare yet critical complication in cancer patients, with high embolic risk and poor prognoses. This systematic review investigates the clinical presentation, valve involvement, embolic risk, vegetation management, and prognostic variability across cancer types in NBTE cases.
Methods: Adhering to PRISMA guidelines, we conducted a comprehensive literature search in PubMed, Scopus, and Embase for studies from 2000 to September 2024.
J Forensic Sci
August 2025
Department of Pathology, Government Medical College, Ernakulam, India.
Sudden cardiac death (SCD) in adolescents is rare and often attributed to previously undiagnosed cardiac conditions, including genetic cardiomyopathies, congenital anomalies, conduction disorders, or thrombotic events. In atypical cases, intracardiac or vascular thromboembolism may resemble vegetations, posing a diagnostic challenge during postmortem evaluation. Thorough investigation, including histopathological analysis, is critical to accurately determine the cause of death.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
August 2025
Department of Cardiovascular Surgery, Kansai Rosai Hospital, Amagasaki, 660-8511, Japan.
We report a case of recurrent nonbacterial thrombotic endocarditis (NBTE) following vegetectomy of bioprosthesis without malignancy or autoimmune disorders. A 76-year-old woman underwent mitral valve replacement with a bioprosthesis for mitral regurgitation. Six years later, an outpatient echocardiography revealed a mobile vegetation incidentally.
View Article and Find Full Text PDFCurr Cardiol Rev
August 2025
Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil.
Introduction: Nonbacterial thrombotic endocarditis (NBTE) involves sterile vegetations on heart valves due to systemic hypercoagulability, often linked to malignancies. It is frequently underdiagnosed and presents significant clinical management challenges, often manifesting as thromboembolic events like ischemic stroke. We aim to report the first case of cancerassociated NBTE that showed a positive response to rivaroxaban as a maintenance anticoagulant, with 3D echocardiographic evidence of vegetation reduction, and to evaluate the performance of direct oral anticoagulants (DOACs) in treating cancer-associated NBTE through a systematic review of case reports.
View Article and Find Full Text PDFCureus
July 2025
Cardiovascular Medicine Department, Mayo Clinic, Phoenix, USA.
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.
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