Seizure as first manifestation of endocarditis in a patient with metastatic pancreatic adenocarcinoma: a case report Case report
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Abstract
Nonbacterial thrombotic endocarditis is a potentially overlooked condition that involves the formation of sterile fibrin vegetations on heart valve leaflets in cancer patients. This condition can lead to
valvular dysfunction, heart failure and systemic embolization. The pathogenesis depends on hypercoagulable states which are common in malignancy scenarios. Diagnosis requires the presence of
valvular vegetations and the absence of infection.
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References
2. Liu J, Frishman WH. Nonbacterial Thrombotic Endocarditis: Pathogenesis, Diagnosis, and Management. Cardiol Rev. 2016; 24(5): 244-7.
3. el-Shami K, Griffiths E, Streiff M. Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment. Oncologist. 2007; 12(5): 518-23.
4. Seok JM, Kim SG, Kim JW et al. Coagulopathy and embolic signal in cancer patients with ischemic stroke. Ann Neurol. 2010; 68(2): 213-9.
5. Deppisch LM, Fayemi AO. Non-bacterial thrombotic endocarditis: clinicopathologic correlations. Am Heart J. 1976; 92(6): 723-9.
6. Sia CH, Lim JS, Poh KK et al. A classical case of non-bacterial thrombotic endocarditis from pancreatic adenocarcinoma presenting as multiple strokes, myocardial infarction and acute limb ischaemia. Oxf Med Case Reports. 2016; 2016(11): omw084.
7. Goldenberg N, Kahn SR, Solymoss S. Markers of coagulation and angiogenesis in cancer-associated venous thromboembolism. J Clin Oncol. 2003; 21(22): 4194-9.
8. Chen X, Chen SD, Dong Y et al. Patent foramen ovale closure for patients with cryptogenic stroke: A systematic review and comprehensive meta-analysis of 5 randomized controlled trials and 14 observational studies. CNS Neurosci Ther. 2018; 24(10): 853-62.
9. Chen PC, Muo CH, Lee YT et al. Lung cancer and incidence of stroke: a population-based cohort study. Stroke. 2011; 42(11): 3034-9.
10. Fitzpatrick T, Carrier M, Le Gal G. Cancer, atrial fibrillation, and stroke. Thromb Res. 2017; 155: 101-5.
11. Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist. 2014; 19(1): 82-93.
12. Prandoni P, Lensing AW, Piccioli A et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood. 2002; 100(10): 3484-8.
13. Mery B, Guichard JB, Guy JB et al. Atrial fibrillation in cancer patients: Hindsight, insight and foresight. Int J Cardiol. 2017; 240: 196-202.
14. Connolly SJ, Ezekowitz MD, Yusuf S et al. RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361(12): 1139-51.
15. Granger CB, Alexander JH, McMurray JJ et al; ARISTOTLE Committees and Investigators: Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011; 365(11): 981-92.
16. Patel MR, Mahaffey KW, Garg J et al; ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011; 365(10): 883-91.
17. Giugliano RP, Ruff CT, Braunwald E et al; ENGAGE AF-TIMI 48 Investigators. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013; 369(22): 2093-104.
18. Russo V, Bottino R, Rago A et al. Atrial Fibrillation and Malignancy: The Clinical Performance of Non-Vitamin K Oral Anticoagulants-A Systematic Review. Semin Thromb Hemost. 2019; 45(2): 205-14.
19. Melloni C, Dunning A, Granger CB et al. Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer: Insights from the ARISTOTLE Trial. Am J Med. 2017;130(12): 1440-8.e1.