biostudies-literatureUnknown32(4)Restelli DNonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis associated with malignancy or autoimmune disorders. Diagnosis remains a challenge as patients are often asymptomatic up to embolic events or rarely, valve dysfunction. We report a case of NBTE with uncommon clinical presentation and identified with multimodal echocardiography. An 82-year-old man presented to our outpatient clinic reporting dyspnea. Past medical history included hypertension, diabetes, kidney disease, and unprovoked deep-vein thrombosis. On physical examination, he was apyretic, mildly hypotensive, and hypoxemic, had a systolic murmur and lower limbs edema. Transthoracic echocardiography revealed severe mitral regurgitation due to verrucous thickening of the free margin of both leaflets, increased pulmonaJournal of cardiovascular echography225-228https://www.ebi.ac.uk/biostudies/studies/S-EPMC10041397biostudies-literatureNonbacterial Thrombotic Endocarditis with Atypical Presentation as Overt Congestive Heart Failure.PMC10041397Restelli DCerto GPiccione MCAndo GManganaro RTrio OPoleggi CZito CfalseNonbacterial Thrombotic Endocarditis with Atypical Presentation as Overt Congestive Heart Failure.Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis associated with malignancy or autoimmune disorders. Diagnosis remains a challenge as patients are often asymptomatic up to embolic events or rarely, valve dysfunction. We report a case of NBTE with uncommon clinical presentation and identified with multimodal echocardiography. An 82-year-old man presented to our outpatient clinic reporting dyspnea. Past medical history included hypertension, diabetes, kidney disease, and unprovoked deep-vein thrombosis. On physical examination, he was apyretic, mildly hypotensive, and hypoxemic, had a systolic murmur and lower limbs edema. Transthoracic echocardiography revealed severe mitral regurgitation due to verrucous thickening of the free margin of both leaflets, increased pulmona2022-01-01T00:00:00Z2022 Oct-Dec2025-04-07T12:24:34.047Z2025-02-19T03:01:59.932ZS-EPMC100413973699412010.4103/jcecho.jcecho_42_22