Nonbacterial thrombotic endocarditis
{{Redirect|NBTE|educational board|National Board for Technical Education}}
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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 {{Transliteration|grc|marantikos}}, meaning "wasting away".{{EMedicine|article|1165712|Neurological Sequelae of Infectious Endocarditis}} The term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state{{cite web |url=http://www.merck.com/mmpe/sec07/ch077/ch077c.html#sec07-ch077-ch077b-1476 |title=Noninfective Endocarditis: Endocarditis: Merck Manual Professional |access-date=2008-12-22}} such as cancer.{{cite web |url=http://cancerweb.ncl.ac.uk/cgi-bin/omd?marantic+endocarditis |title=Marantic endocarditis |website=Online Medical Dictionary |access-date=2008-12-22}}
Risk factors
Marantic vegetations are often associated with previous rheumatic fever. Other risk factors include:{{citation needed|date=January 2021}}
- hypercoagulable states
- malignant cancers, especially mucin-producing adenocarcinomas (most commonly associated with pancreatic adenocarcinomas)
- systemic lupus erythematosus: Referred to as Libman-Sacks endocarditis
- trauma (e.g., catheters)
- Antiphospholipid syndrome
=Valve predilection=
The disease affects the valves with following predilection: mitral valve > aortic valve > tricuspid valve > pulmonary valve{{Cite web | url=https://www.uptodate.com/contents/nonbacterial-thrombotic-endocarditis |title = UpToDate}}
Histopathology
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{{DorlandsDict|nine/000952354|nonbacterial thrombotic endocarditis}} (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.{{citation needed|date=October 2021}}
Diagnosis
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|date=January 2021}}
References
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External links
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{{Heart diseases}}
{{Paraneoplastic syndromes}}