Nonbacterial thrombotic endocarditis

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Nonbacterial thrombotic endocarditis
Classification and external resources
DiseasesDB 29250

Non-bacterial thrombotic endocarditis (NBTE) is the deposition of small sterile vegetations on 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]


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[4] (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.

Risk factors[edit]

Marantic vegetations are often associated with previous rheumatic fever.

Other risk factors include:

Valve predilection[edit]

The disease affects the valves with the following predilection:

aortic valve > mitral valve > tricuspid valve > pulmonary valve [5]


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 the diagnosis of NBTE. An echocardiograph may be used to further assess for valvular lesions.


  1. ^ "eMedicine - Neurological Sequelae of Infectious Endocarditis : Article by Milind J Kothari". Retrieved 2008-03-23. 
  2. ^ "Noninfective Endocarditis: Endocarditis: Merck Manual Professional". Retrieved 2008-12-22. 
  3. ^ "Definition: marantic endocarditis from Online Medical Dictionary". Retrieved 2008-12-22. 
  4. ^ "nonbacterial thrombotic endocarditis" at Dorland's Medical Dictionary
  5. ^ Surgical pathology of nonbacterial thrombotic endocarditis in 30 patients, 1985-2000. Eiken PW, Edwards WD, Tazelaar HD, McBane RD, Zehr KJ . Mayo Clin Proc. 2001 Dec;76(12):1204-12