[Nonbacterial thrombotic endocarditis as initial event of lung cancer].
Nonbacterial thrombotic endocarditis (NBTE) is a rare cause of peripheral embolism. NBTE is usually associated with malignant diseases and hypercoagulability states. Echocardiography is a very useful technique for the diagnosis. However valvular lesions in NBTE are similar to valvular vegetations observed from infectious endocarditis (IE), so it s necessary to establish a differential diagnosis. The treatment of thrombotic endocarditis is controversial, but the literature coincides in the use of intravenous heparin. We describe the case of a 42 years old woman with stroke in which transesophageal echocardiography (TEE) was useful in establishing the diagnosis of NBTE. The infectious origin was excluded with the realization of a exhaustive microbiologic study. In the search of causes for NBTE a lung adenocarcinoma was detected. In the present case the diagnosis of endocarditis preceded the neoplastic disease diagnosis.
Herrera de Pablo
P
P
Servicio de Medicina Interna, Hospital Arnau de Vilanova, Valencia, Spain.
Esteban Esteban
E
E
Giménez Soler
J V
JV
Pareja Martínez
A
A
Moscoso del Prado
J
J
D000328:Adult; D003937:Diagnosis, Differential; D004696:Endocarditis / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D020521:Stroke / Q000209:etiology*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*