Nonbacterial Thrombotic Endocarditis with Embolic Vascular Events as A Manifestation of Advanced Pancreatic Cancer: A Case Report

Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, is a very rare complication of malignancy and other hypercoagulable states that is characterized by deposition of sterile vegetations (consisting of thrombi and fibrin) on the heart valves. The most commonly affected valves are the aortic valve, the mitral valve or both simultaneously; involvement of the right heart valves is less common. The marantic endocarditis occurs in the context of noninfectious chronic inflammatory conditions, particularly visceral malignancies, and the vegetations are much more prone to detach and embolize as compared to infectious endocarditis. Patients typically present with signs and symptoms of arterial emboli, such as ischemic cerebral events and acute coronary syndromes.