Frontiers in Cardiovascular Medicine (Jul 2023)

Case report: New is not always better: treatment of non-bacterial thrombotic endocarditis

  • Elias Akiki,
  • Ali Ahmad,
  • Ali Ahmad,
  • Edward A. El-Am,
  • Ana I. Casanegra,
  • Kyle W. Klarich,
  • Reto Kurmann

DOI
https://doi.org/10.3389/fcvm.2023.1208190
Journal volume & issue
Vol. 10

Abstract

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An elderly female with metastatic adenocarcinoma of the lung and atrial fibrillation presented with multiple embolic strokes while on anticoagulation with Apixaban. After further investigation, a TEE showed lesions of non-bacterial thrombotic endocarditis on the mitral valve. A decision to switch the patient to LMWH for anticoagulation was then made and a follow-up TEE showed resolution of the NBTE. In this abstract, we show that heparin should remain as the anticoagulation agent of choice in the setting of NBTE associated with malignancy.

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