Ladera Santos Diana, Roldán Guerra Álvaro, Dávila Flores Viviana, Anguita Sánchez Manuel
Departament of Cardiology, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n, 14004 Córdoba, Spain.
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Avenida Menéndez Pidal s/n, 14004 Córdoba, Spain.
Eur Heart J Case Rep. 2024 Nov 21;8(12):ytae617. doi: 10.1093/ehjcr/ytae617. eCollection 2024 Dec.
Nonbacterial thrombotic endocarditis (NBTE) is an uncommon and often underdiagnosed condition characterized by a state of hypercoagulability. We present a case of a patient with ulcerative colitis who experienced a non-ST-segment elevation myocardial infarction as a rare complication of NBTE.
We report a case of a 16-year-old male with a history of ulcerative colitis who presented to the emergency department with chest pain at rest. He was admitted to the cardiology ward with an initial suspected diagnosis of acute myocarditis. Transthoracic echocardiography revealed inferior septobasal hypokinesia and a mobile pedunculated mass attached to the aortic valve, although the valve's function was not compromised.Given the suspicion of an acute coronary syndrome of embolic origin, cardiac magnetic resonance imaging (MRI) with intravenous contrast was performed. The MRI revealed an evolved infarct in the territory of the right coronary artery. Biopsy of the material removed during surgery revealed findings consistent with thrombotic material.
We present a case of acute coronary syndrome as an unusual manifestation of NBTE in a patient with ulcerative colitis. Although we have not identified any reported cases in the literature involving ulcerative colitis, it is crucial to consider NBTE in patients with underlying conditions that predispose them to a procoagulant state. Furthermore, it is necessary to define criteria or guidelines for its diagnosis or treatment.
非细菌性血栓性心内膜炎（NBTE）是一种罕见且常被漏诊的疾病，其特征为高凝状态。我们报告一例溃疡性结肠炎患者，该患者发生非ST段抬高型心肌梗死，这是NBTE一种罕见的并发症。
我们报告一例16岁男性，有溃疡性结肠炎病史，因静息时胸痛就诊于急诊科。他最初被怀疑诊断为急性心肌炎而入住心内科病房。经胸超声心动图显示下间隔基底段运动减弱，主动脉瓣上有一个活动的带蒂肿块，尽管瓣膜功能未受影响。鉴于怀疑为栓子来源的急性冠状动脉综合征，进行了静脉注射造影剂的心脏磁共振成像（MRI）检查。MRI显示右冠状动脉供血区域有陈旧性梗死。手术中切除物质的活检结果显示与血栓物质相符。
我们报告一例急性冠状动脉综合征，这是溃疡性结肠炎患者中NBTE的一种不寻常表现。尽管我们在文献中未发现任何涉及溃疡性结肠炎的报道病例，但对于有易导致促凝状态基础疾病的患者，考虑NBTE至关重要。此外，有必要为其诊断或治疗制定标准或指南。
