Philippine Journal of Neurology 2025;28(1):21-24
Tri-valvular nonbacterial thrombotic endocarditis presenting as a stroke in the young
Miriam Angeline G. Antonio 1 ; Vincent B. Macalintal 1
Affiliations
Country
Philippines
Language
English
MeSH
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Abstract
This is a case of a 44 year old single, Filipino, female who presented with dysarthria, left central facial paresis, left hemianopsia and left hemiparesis. Magnetic Resonance Imaging showed an acute infarction of the right posterior cerebral artery territory. 2d echo and transesophageal echocardiography were done and vegetations were observed on the mitral, aortic and tricuspid valves giving a diagnosis of endocarditis. With the absence of fever and negative blood cultures, infective endocarditis was less likely. On further workup, computed tomography scan of the abdomen showed a probable malignant ovarian mass. This finding led to a diagnosis of nonbacterial thrombotic endocarditis as the cause of the stroke. Endocarditis as a cause of an embolic event in the brain is uncommon and nonbacterial thromobotic endocarditis is rare. It commonly affects the left sided heart valves. Multivalvular involvement which includes the right sided heart valves are rarely reported. Nonbacterial thrombotic endocarditis has a high mortality so therefore early detection and management is crucial and can be life-saving.
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