Nonbacterial (marantic) endocarditis is associated with a number of clinical and laboratory findings related to vegetations on one or more cardiac valves. Complications of these vegetations can be disabling for the patient.


Clinical findings:

(1) history of a condition associated with nonbacterial endocarditis (see previous section)

(2) arterial and/or pulmonary thromboemboli


Arterial thromboemboli can go to:

(1) the coronary arteries, with acute myocardial infarction

(2) the cerebral arteries, with stroke

(3) the mesenteric arteries, with ischemic bowel disease

(4) the renal arteries, with renal infarctions

(5) arteries in the extremities

(6) small arteries in the skin or conjunctiva, with splinter hemorrhages or Roth spots


Imaging findings:

(1) vegetations on one or more cardiac valves, best seen on echocardiography


Laboratory findings:

(1) negative blood cultures

(2) elevated D-dimer

(3) fibrinogen may be decreased, normal or elevated


The vegetations may become infected if the patient develops bacteremia but this process would be hard to document.


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