Nonbacterial thrombotic endocarditis
|Nonbacterial thrombotic endocarditis|
|Other names: Marantic endocarditis|
|a,b) Transthoracic echocardiography - NBTE arrow c.d) after anticoagulation therapy lesion practically disappeared|
|Symptoms||Typically no symptoms|
|Causes||Platelet and fibrin emboli attached to heart valves|
|Treatment||No effective treatment, anticoagulation|
Nonbacterial thrombotic endocarditis (NBTE) is a form of inflammation of the heart in which small sterile vegetations are deposited on the valves. There are typically no symptoms, but has the possibility of presenting with symptoms of stroke.
It is caused by small platelet and fibrin emboli attached to the heart valves.
Signs and symptoms
- 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 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.
- McKenna, William J.; Elliott, Perry M. (2020). "54. Diseases of the myocardium and endocardium". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 1 (26th ed.). Philadelphia: Elsevier. p. 312. ISBN 978-0-323-55087-1. Archived from the original on 2022-11-12. Retrieved 2022-11-05.
- "Noninfective Endocarditis - Cardiovascular Disorders". Merck Manuals Professional Edition. Archived from the original on 22 April 2021. Retrieved 26 October 2021.
- Langston, Matthew C.; Zack, Chad J.; Fender, Erin Amanda (26 September 2022). "Non-bacterial thrombotic endocarditis: manifestations and diagnosis in the age of echocardiography". Heart (British Cardiac Society). 108 (20): 1590–1591. doi:10.1136/heartjnl-2022-321223. ISSN 1468-201X. PMID 35609961. Archived from the original on 25 May 2022. Retrieved 5 November 2022.
- Neurological Sequelae of Infectious Endocarditis at eMedicine