Nonbacterial thrombotic endocarditis
|Nonbacterial thrombotic endocarditis|
|a,b) Transthoracic echocardiography - NBTE arrow c.d) after anticoagulation therapy lesion practically disappeared|
Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis, which comes from the Greek marantikos, meaning "wasting away". The term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state such as cancer.
Signs and symptoms
The clinical presentation of this condition is consistent with the following:
- Heart murmur
- hypercoagulable states
- malignant cancers, especially mucin-producing adenocarcinomas (most commonly associated with pancreatic adenocarcinomas)
- systemic lupus erythematosus: Referred to as Libman-Sacks endocarditis
- trauma (e.g., catheters)
Grossly, vegetations form along lines of valve closure and are generally symmetric with a smooth or verrucoid (warty) texture. Histologically, lesions are composed of fibrin (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.
Due to the non-invasive nature of NBTE, clinical examination may or may not reveal a new murmur. An embolic stroke may be the first feature to suggest diagnosis of NBTE. An echocardiograph may be used to further assess for valvular lesions.
Nonbacterial thrombotic endocarditis treatment consists of the following: 
- Treating underlying disease
- Systemic anticoagulation
- Surgical intervention
- Neurological Sequelae of Infectious Endocarditis at eMedicine
- "Noninfective Endocarditis: Endocarditis: Merck Manual Professional". Retrieved 2008-12-22.
- "Marantic endocarditis". Online Medical Dictionary. Retrieved 2008-12-22.
- "Noninfective Endocarditis - Cardiovascular Disorders". Merck Manuals Professional Edition. Retrieved 26 October 2021.
- "nonbacterial thrombotic endocarditis" at Dorland's Medical Dictionary
- Liu, Joshua; Frishman, William H. (September 2016). "Nonbacterial Thrombotic Endocarditis: Pathogenesis, Diagnosis, and Management". Cardiology in Review. 24 (5): 244–247. doi:10.1097/CRD.0000000000000106. ISSN 1538-4683. Retrieved 26 October 2021.