title: A classical case of non-bacterial thrombotic endocarditis from pancreatic adenocarcinoma presenting as multiple strokes, myocardial infarction and acute limb ischaemia.
abstract: Non-bacterial thrombotic endocarditis (NBTE) classically presents in the context of pancreatic adenocarcinomas. Echocardiography is useful to investigate for valvular vegetations, and institution of early treatment is crucial as this can be complicated by multiple systemic emboli, leading to significant morbidity or mortality in serious cases. Treatment options involve anticoagulation with unfractionated heparin, and the role of surgical intervention is unclear. In this report, we describe a classical case of a middle-aged lady with unresectable pancreatic adenocarcinoma who developed NBTE complicated by multiple systemic emboli. She eventually succumbed from poor neurological status from multiple cerebral emboli. Awareness of this condition is required by clinicians for early diagnosis and prompt treatment.
authors.affiliation: University Medicine Cluster , National University Health System , Singapore.
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Sia
authors.affiliation: Department of Haematology-Oncology , National University Cancer Institute , Singapore.
authors.forename: Joline Si Jing
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Cardiology , National University Heart Centre Singapore , Singapore.
authors.forename: Kian Keong
authors.initials: KK
authors.lastname: Poh
authors.affiliation: Department of Haematology-Oncology , National University Cancer Institute , Singapore.
authors.forename: Tan Min
authors.initials: TM
authors.lastname: Chin