Non-bacterial thrombotic endocarditis: a case report with favorable evolution and literature review

Abstract

Nonbacterial thrombotic endocarditis is an uncommon disease characterized by formation and deposition of sterile fibrin vegetations on heart valves. This condition is more related to states of chronic inflammation, mainly related to malignancy. This report describes the case of a Brazilian woman, 50 years old, smoker, diagnosed with pulmonary adenocarcinoma with pleural and bone metastases after presenting with deep venous thrombosis and pulmonary embolism. During the investigation, a transthoracic echocardiogram was performed, which revealed a mobile echogenic mass in the mitral leaflet. As there were no suggestive signs or laboratory tests that corroborated a systemic bacterial infection, the diagnosis of non-bacterial thrombotic endocarditis was confirmed. Given the poor prognosis related to the disease, suspicion and early treatment were determining factors for the favorable evolution presented.