Non-bacterial thrombotic endocarditis

Last revised by Daniel J Bell on 10 Jul 2021

Non-bacterial thrombotic endocarditis (NBTE), also known as marantic endocarditis, refers to fibrin and platelets' aggregations on previously undamaged heart valves, in the absence of bacteremia. The condition is seen in advanced stage malignancies and is related to multisystemic emboli. 


Non-bacterial thrombotic endocarditis is usually present in patients ranging between the 4th and the 8th decades of life, however, the real incidence is unknown 1,2.

Risk factors

A higher incidence has been reported among patients with advanced stage malignancies, connective tissue disorders, autoimmune disorders (e.g. systemic lupus erythematosus), and hypercoagulable states 1-3

Clinical presentation

The condition has no specific clinical signs or symptoms. Presence of a new heart murmur on clinical examination has been reported. Signs of multiple systemic emboli without a known source or an infectious process will raise the possibility of this diagnosis. 

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