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Marantic endocarditis

Introduction

Marantic endocarditis, also known as non-bacterial thrombotic endocarditis (NBTE), is the deposition of small sterile vegetations on valve leaflets. Marantic vegetations are often associated with previous rheumatic fever. Other risk factors include:

The disease affects the valves with the following predilection:

mitral valve > aortic valve > tricuspid valve > pulmonary valve.

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 (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.

It is imperative to take the blood pressure in both arms.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]