Abstract
Nonbacterial thrombotic endocarditis (NBTE) is a rare clinical condition characterized by the presence of sterile vegetations on valvular leaflets Gross and Friedberg (1936). The most frequent cause of NBTE is antiphospholipid syndrome Hughson and et al. (1993); malignancy, through an intrinsic condition of hypercoagulability, is the second most common cause Thomas (2001). Systemic thromboembolic complications are frequently associated with this condition, but coronary embolism is not common. We report the case of a patient with NBTE secondary to gastric adenocarcinoma with clinical symptoms of coronary and systemic emboli.
Highlights
Nonbacterial thrombotic endocarditis (NBTE) is a rare clinical condition characterized by the presence of sterile vegetations on valvular leaflets Gross and Friedberg (1936)
We report the case of a patient with NBTE secondary to gastric adenocarcinoma with clinical symptoms of coronary and systemic emboli
NBTE is characterized by the formation of vegetations on heart valves in the absence of systemic bacterial infections
Summary
A 43-year-old previously healthy woman presented with sudden onset of substernal chest pain that had begun some hours earlier She had no history of coronary artery disease. The patient complained of nausea and persistent vomiting; an elevated plasma level of CA-19.9 was detected: as a result, a fiberoptic gastroscopy with biopsy was performed. This revealed the presence of a 4 cm by 3 cm mass on the lesser curvature, identified as a gastric adenocarcinoma at the pathological examination. A second TEE demonstrated persistence and enlargement of the two vegetations previously seen on the mitral leaflets, in spite of the anticoagulant therapy which had been promptly started.
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