Nonbacterial thrombotic endocarditis

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Nonbacterial thrombotic endocarditis
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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".[1] The term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state[2] such as cancer.[3]

Signs and symptoms

The clinical presentation of this condition is consistent with the following:[4]

  • Dyspnea
  • Palpitations
  • Fever
  • Heart murmur

Risk factors

Marantic vegetations are often associated with previous rheumatic fever. Other risk factors include:[citation needed]

Valve predilection

The disease affects the valves with following predilection: mitral valve > aortic valve > tricuspid valve > pulmonary valve[5]


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[6] (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.[citation needed]


Nonbacterial thrombotic endocarditis treatment consists of the following: [7]

  • Treating underlying disease
  • Systemic anticoagulation
  • Surgical intervention


  1. Neurological Sequelae of Infectious Endocarditis at eMedicine
  2. "Noninfective Endocarditis: Endocarditis: Merck Manual Professional". Retrieved 2008-12-22.
  3. "Marantic endocarditis". Online Medical Dictionary. Retrieved 2008-12-22.
  4. "Noninfective Endocarditis - Cardiovascular Disorders". Merck Manuals Professional Edition. Retrieved 26 October 2021.
  5. "UpToDate".
  6. "nonbacterial thrombotic endocarditis" at Dorland's Medical Dictionary
  7. 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.

External links

External resources