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01-09-2017 | Heart Beat | Uitgave 12/2017 Open Access

Netherlands Heart Journal 12/2017

A 46-year-old man with recurrent embolic events

Netherlands Heart Journal > Uitgave 12/2017
T. Lorjé, N. Barlo, C. L. A. Reichert, W. de Kanter, M. A. Sluman
A 46-year-old male with advanced adenocarcinoma of the lung presented with venous thrombosis. Despite anticoagulants, he developed a stroke and bowel ischaemia. Echocardiography revealed mobile structures on the mitral valve and at the pulmonary artery origin (Fig.  1). Although treatment for endocarditis and pulmonary embolism was initiated, his condition deteriorated. However, blood cultures remained negative and fever was absent. Non-bacterial thrombotic endocarditis (NBTE) became more likely after establishing progressive malignancy with PET-CT. NBTE is found in 19% of patients with malignancy and thrombotic events, but often not recognised [ 1]. It is distinguished from infective endocarditis by location of the valvular mass, absence of infection, diffuse thickening of valve leaflets and usual absence of valvular dysfunction [ 2, 3]. Treatment involves oncological therapy and anticoagulants [ 4]. Surgery may be considered in progressive valvular disease or recurrent embolism [ 5]. NBTE should be part of the differential diagnosis in patients with malignancy and thromboembolic complications.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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