| Nonbacterial thrombotic endocarditis | |
|---|---|
| Specialty | Cardiology  |
| Treatment | Anticoagulation |
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]
Marantic vegetations are often associated with previous rheumatic fever. Other risk factors include:[ citation needed ]
The disease affects the valves with following predilection: mitral valve > aortic valve > tricuspid valve > pulmonary valve [4]
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 [5] (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.[ citation needed ]
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 echocardiogram is essential for visualization of the mass.[ citation needed ]