Non-bacterial endocarditis in malignant neoplastic diseases: an echocardiographic study

Abstract

Under physiological conditions, normal function of the human haemostatic system is maintained by actions of pro- and anticoagulant forces(Bick , 2003). In patients with cancer, this delicate balance may be altered, and the occurrence of a coagulopathic and embolic complications may provide the first evidence of an underlying cancer ( Perez-lazaro et al, 2004). These are paraneoplastic disorders which called Trousseau syndrome that occurs at a distance from the prima ry tum or or metastasis and are induced by the cancer through hormo1es, immunoglubins, other humoral medi ators, or endothelial damage (Chen et al, 2004). Nonbacterial endocard itis, one clinical entity of Trousseau syndrome and the result of complex pathologi cal process involving platelet and fibrin, is characterized by blunt fibrin - platelet thrombus on cardiac valves in the absence of micro­ org nisms (Mark et al, 2004 and Frazer et al, 2005). The valvular lesions of non-bacterial thrombotic endocarditis usually affect the mitral and the aortic valves, although all valves can be affected (Edoute et al, 1997 and Merle et a t, 200 I ) Nonbacteri al thromboti c endocarditis can com plicate any can cer except brain tumor (Edoute et al, 1 997). However, Streiff (2004) recorded thromboembolism including NBTE. in patients wi th mali gnant gliomas. Nonbacterial endocarditis may be symptomati c and cause significant morbidity and mortality as a res ult of major systemic embolism. The cerebral, coronary, renal, and mesenteric circul ation being