Failure of oral anti-Xa to prevent non-bacterial thrombotic endocarditis in cancer: case report and literature review

This rare case of ME in a cancer patient, despite treatment with a direct oral anticoagulant, raises important considerations. Although cases are scarce in the literature, it highlights the complexities of anticoagulation management in oncology, suggesting that the hypercoagulable state may surpass the protective effects of these medications. This case underscores the need for enhanced cardiac monitoring and a tailored anticoagulation approach, even for patients under anticoagulant therapy. It advocates for re-evaluating follow-up protocols and anticoagulant selection in this clinical context.