The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic. Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients. Patients with NBTE may have a positive history of malignancy, disseminated intravascular coagulation, antiphospholipid syndrome, autoimmune disease such as systemic lupus erythematosus, e.t.c

• The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic^[1].
• Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients^{[2][3]_The_BMJ-4|[4]}.
• The most common presentation of NBTE is a sudden stroke^[5].
• About 50% of patients with NBTE present with new or a change in existing cardiac murmurs.
• Murmurs are usually non-specific systolic murmurs commonly located in the left lower sternal border^[6].
• Valvular deficiency or heart failure is an uncommon initial presentation^[7].

Patients with NBTE may have a positive history of^{[1][8]_IntechOpen-9|[9]};

• Malignancy
• Disseminated intravascular coagulation
• Antiphospholipid syndrome
• Autoimmune disease such as systemic lupus erythematosus

In alphabetical order, some of the common manifestations and symptoms of NTBE include:

• Signs of cerebrovascular embolism i.e^[5];
  • Amnesia
  • Delirium
  • Dysphagia
  • Dysphasia
  • Dysarthria
  • Localized/diffuse weakness
  • Localized/diffuse numbness
  • Psychomotor agitation
  • Seizures
  • Vision loss

• Signs of heart failure secondary to defective valves i.e^[7];
  • Chest pain
  • Dyspnea
  • Lethargy
  • Orthopnea
  • Paroxysmal nocturnal dyspnea
  • Peripheral edema

• Symptoms due to underlying systemic lupus erythematosus^[8];
  • Arthritis
  • Hematuria
  • Rash
  • Sweating
  • Fatigue

• Signs of systemic thromboembolism i.e^[10][11][12];
  • Acute abdominal syndromes;
    • Flank pain due to kidney infarction
    • Nausea
    • Pain
    • Vomiting
  • Raynaud’s phenomenon due to embolization to the skin

In alphabetical order, some of the less common manifestations and symptoms of NBTE include;

• Secondary infective endocarditis
  • Chest pain
  • Fever
  • Night sweats
  • Weightloss