Marantic endocarditis

Rev Esp Anestesiol Reanim (Engl Ed). 2020 Apr;67(4):208-211. doi: 10.1016/j.redar.2020.01.005. Epub 2020 Mar 2.
[Article in English, Spanish]


Marantic endocarditis is characterized by the presence of sterile vegetations in the heart valves, and is associated with hypercoagulability states (cancer, autoimmune diseases, HIV). Its main complications are stroke, pulmonary thromboembolism, acute intestinal ischemia and splenic, renal and hepatic infarcts. We present the case of a 57-year-old patient with a history of uterine neoplasia. She went to the emergency department due to sudden loss of strength in the left side of the body. A computed tomography (CT) scan showed right ischemic stroke, and she underwent endovascular reperfusion and thrombectomy. Four days later, she suffered acute respiratory failure, with angio-CT showing pulmonary thromboembolism. Later, paroxysmal atrial fibrillation and distal ischemia in the second toe of the left foot appeared. She was diagnosed with marantic endocarditis by means of transesophageal echocardiography, and died 72h later due to multiorgan failure. Early diagnosis and treatment with anticoagulation can reduce the mortality of this disease, since it is underdiagnosed, and often only comes to light during postmortem examination.

Keywords: Anticoagulación; Anticoagulation; Diagnosis; Diagnóstico; Ecocardiograma transesofágico; Endocarditis marántica; Endocarditis trombótica no bacteriana; Endocarditis tumoral; Marantic endocarditis; Nonbacterial thrombotic endocarditis; Transesophageal echocardiography; Tratamiento; Treatment.

Publication types

  • Case Reports

MeSH terms

  • Atrial Fibrillation / etiology
  • Echocardiography, Transesophageal
  • Endocarditis, Non-Infective / complications*
  • Endocarditis, Non-Infective / diagnosis
  • Fatal Outcome
  • Female
  • Humans
  • Intestines / blood supply
  • Ischemia / diagnosis
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / etiology
  • Middle Aged
  • Mitral Valve Insufficiency / diagnostic imaging
  • Pulmonary Embolism / etiology
  • Respiratory Insufficiency / diagnostic imaging
  • Toes / blood supply