Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up
We reported a case of non-bacterial thrombotic endocarditis (NBTE) in a 37-year-old woman who presented with signs and symptoms of cardio-embolic cerebral stroke caused by a prothrombotic state due to underlying advanced uterine cancer. Multimodal imaging, including 3D-ecocardiography, as well as l...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-10-01
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| Series: | Monaldi Archives for Chest Disease |
| Subjects: | |
| Online Access: | https://monaldi-archives.org/index.php/macd/article/view/2729 |
| _version_ | 1797663131266187264 |
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| author | Vito Maurizio Parato Sara Belleggia Andrea Giovanni Parato Umberto Ianni Michela Molisana Germana Gizzi Simone D'Agostino Melissa Dottori Marco Di Eusanio |
| author_facet | Vito Maurizio Parato Sara Belleggia Andrea Giovanni Parato Umberto Ianni Michela Molisana Germana Gizzi Simone D'Agostino Melissa Dottori Marco Di Eusanio |
| author_sort | Vito Maurizio Parato |
| collection | DOAJ |
| description |
We reported a case of non-bacterial thrombotic endocarditis (NBTE) in a 37-year-old woman who presented with signs and symptoms of cardio-embolic cerebral stroke caused by a prothrombotic state due to underlying advanced uterine cancer. Multimodal imaging, including 3D-ecocardiography, as well as laboratory and cultural tests, were critical in making the diagnosis. After starting anticoagulation therapy with low molecular weight heparin (LMWH), the patient underwent surgical aortic valve replacement due to worsening aortic valve function, initial left ventricle enlargement, increasing dimensions, and mobility of vegetations. Unfortunately, vegetations relapsed on the aortic valve bio-prosthesis as well as the mitral leaflets, resulting in a final picture of multi-valve NBTE. The fatal outcome was due to a massive multiple limb embolism, which resulted in leg amputations and septical complications. Starting with the case, we present a brief overview of the pathology's presentation, treatment, management, and prognosis, as well as the diagnostic work-up.
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| first_indexed | 2024-03-11T19:10:09Z |
| format | Article |
| id | doaj.art-5f93e534f6384f37a3901b4020c6a1d1 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-03-11T19:10:09Z |
| publishDate | 2023-10-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-5f93e534f6384f37a3901b4020c6a1d12023-10-09T18:51:04ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642023-10-0110.4081/monaldi.2023.2729Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-upVito Maurizio Parato0Sara Belleggia1Andrea Giovanni Parato2Umberto Ianni3Michela Molisana4Germana Gizzi5Simone D'Agostino6Melissa Dottori7Marco Di Eusanio8Cardiology and Rehabilitation Unit, Emergency Department, Madonna del Soccorso Hospital, San Benedetto del Tronto; Post-Graduation School of Cardiovascular Diseases, School of Medicine, Università Politecnica delle Marche, AnconaPost-Graduation School of Cardiovascular Diseases, School of Medicine, Università Politecnica delle Marche, AnconaCardiology Division and Chair, “Tor Vergata” University Hospital, RomeCardiology and Rehabilitation Unit, Emergency Department, Madonna del Soccorso Hospital, San Benedetto del TrontoCardiology and Rehabilitation Unit, Emergency Department, Madonna del Soccorso Hospital, San Benedetto del TrontoCardiology and Rehabilitation Unit, Emergency Department, Madonna del Soccorso Hospital, San Benedetto del TrontoCardiology and Rehabilitation Unit, Emergency Department, Madonna del Soccorso Hospital, San Benedetto del TrontoCardiology Unit and Echolab, Cardiovascular Sciences Department, University Hospital Lancisi-Salesi, AnconaCardiac Surgery Unit and Cardiovascular Sciences Department, University Hospital Lancisi-Salesi, Università Politecnica delle Marche, Ancona We reported a case of non-bacterial thrombotic endocarditis (NBTE) in a 37-year-old woman who presented with signs and symptoms of cardio-embolic cerebral stroke caused by a prothrombotic state due to underlying advanced uterine cancer. Multimodal imaging, including 3D-ecocardiography, as well as laboratory and cultural tests, were critical in making the diagnosis. After starting anticoagulation therapy with low molecular weight heparin (LMWH), the patient underwent surgical aortic valve replacement due to worsening aortic valve function, initial left ventricle enlargement, increasing dimensions, and mobility of vegetations. Unfortunately, vegetations relapsed on the aortic valve bio-prosthesis as well as the mitral leaflets, resulting in a final picture of multi-valve NBTE. The fatal outcome was due to a massive multiple limb embolism, which resulted in leg amputations and septical complications. Starting with the case, we present a brief overview of the pathology's presentation, treatment, management, and prognosis, as well as the diagnostic work-up. https://monaldi-archives.org/index.php/macd/article/view/2729NBTEprothrombotic statecerebrovascular stroke malignancy |
| spellingShingle | Vito Maurizio Parato Sara Belleggia Andrea Giovanni Parato Umberto Ianni Michela Molisana Germana Gizzi Simone D'Agostino Melissa Dottori Marco Di Eusanio Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up Monaldi Archives for Chest Disease NBTE prothrombotic state cerebrovascular stroke malignancy |
| title | Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up |
| title_full | Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up |
| title_fullStr | Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up |
| title_full_unstemmed | Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up |
| title_short | Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up |
| title_sort | multi valve libman sacks s endocarditis related multiple massive and fatal systemic embolization a case report and a review of diagnostic work up |
| topic | NBTE prothrombotic state cerebrovascular stroke malignancy |
| url | https://monaldi-archives.org/index.php/macd/article/view/2729 |
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