TY - JOUR
T1 - Non-bacterial thrombotic endocarditis and coronary thrombectomy in a patient with metastatic small cell lung carcinoma
AU - Gray, Kelsey Margaret
AU - Nguyen, Bao
AU - Baker, Larissa
AU - Ahmad, Masood
N1 - Funding Information:
The treatment results in the cases mentioned suggest a platelet-driven process, rather than only a coagulation factor-based phenomenon. This pathogenesis is supported by the composition of vegetations being mainly fibrin and platelets.8
Publisher Copyright:
©
PY - 2021/6/21
Y1 - 2021/6/21
N2 - A 66-year-old Caucasian man was initially admitted with a metastatic small cell lung carcinoma, hyponatraemia and obstructive pneumonia. His transthoracic echocardiogram (TTE) was normal. Ten days after admission, he was diagnosed with a non-ST segment elevation myocardial infarction (MI). Both a repeated TTE and a transoesophageal echocardiogram identified thickened, myxomatous mitral valve leaflet tips with small, mobile masses identified as vegetations, and new, eccentric, severe mitral regurgitation. Subsequent cardiac catheterisation recorded thrombotic occlusion of the right coronary artery. Successful coronary thrombectomy was carried out, but the patient died. A diagnosis of non-bacterial thrombotic endocarditis leading to coronary embolisation and MI was made. The clinical course and treatment choices are discussed.
AB - A 66-year-old Caucasian man was initially admitted with a metastatic small cell lung carcinoma, hyponatraemia and obstructive pneumonia. His transthoracic echocardiogram (TTE) was normal. Ten days after admission, he was diagnosed with a non-ST segment elevation myocardial infarction (MI). Both a repeated TTE and a transoesophageal echocardiogram identified thickened, myxomatous mitral valve leaflet tips with small, mobile masses identified as vegetations, and new, eccentric, severe mitral regurgitation. Subsequent cardiac catheterisation recorded thrombotic occlusion of the right coronary artery. Successful coronary thrombectomy was carried out, but the patient died. A diagnosis of non-bacterial thrombotic endocarditis leading to coronary embolisation and MI was made. The clinical course and treatment choices are discussed.
KW - cancer - see oncology
KW - cardiovascular medicine
KW - cardiovascular system
KW - interventional cardiology
KW - valvar diseases
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U2 - 10.1136/bcr-2020-239893
DO - 10.1136/bcr-2020-239893
M3 - Article
C2 - 34155006
AN - SCOPUS:85108545571
SN - 1757-790X
VL - 14
JO - BMJ Case Reports
JF - BMJ Case Reports
IS - 6
M1 - e239893
ER -