Nonbacterial thrombotic endocarditis

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Nonbacterial thrombotic endocarditis
Classification and external resources
Specialty cardiology
DiseasesDB 29250

Non-bacterial 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]


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: mitral valve > aortic 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.