Marantic endocarditis
| Marantic endocarditis | |
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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:
- hypercoagulable states,
- mucin-producing adenocarcinomas,
- lupus and
- trauma (e.g., catheters).
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.