Marantic Endocarditis (मैरेंटिक एंडोकार्डिटिस) एक rare non-bacterial thrombotic endocarditis (NBTE) है, जिसमें heart valves पर sterile vegetations बन जाते हैं।
- यह condition अक्सर chronically ill patients में देखी जाती है।
- Commonly associated conditions हैं: advanced malignancy, chronic wasting disease, systemic lupus erythematosus (SLE)।
- नाम “Marantic” ग्रीक शब्द marantikos से आया है, जिसका अर्थ है wasting या thin।
- Unlike infectious endocarditis, इसमें bacterial infection नहीं होता, इसलिए इसे non-infective endocarditis भी कहते हैं।
Marantic Endocarditis क्या है (What is Marantic Endocarditis)
- Formation of sterile thrombi on heart valves (usually mitral or aortic)
- Often asymptomatic initially
- Can lead to systemic embolization (stroke, organ infarction)
- Usually associated with hypercoagulable state
Marantic Endocarditis कारण (Causes of Marantic Endocarditis)
1. Malignancy
- Most common cause: advanced cancers, especially adenocarcinomas of pancreas, lung, colon
- Hypercoagulable state in malignancy promotes vegetation formation
2. Chronic Diseases / Wasting Disorders
- Severe malnutrition
- Chronic infections or debilitating illnesses
3. Autoimmune Diseases
- Systemic lupus erythematosus (SLE) – sometimes overlapping with Libman-Sacks endocarditis
4. Hypercoagulable States
- Thrombophilia, antiphospholipid syndrome
Marantic Endocarditis लक्षण (Symptoms of Marantic Endocarditis)
Mostly asymptomatic, but complications cause:
- Embolic phenomena – stroke, renal infarction, splenic infarction
- Heart murmur (new onset)
- Fatigue, weakness, weight loss
- Fever usually absent (differentiates from infectious endocarditis)
- Rarely, heart failure symptoms if valve function compromised
Symptoms largely depend on embolization or underlying disease।
Marantic Endocarditis कैसे पहचाने (Diagnosis of Marantic Endocarditis)
- Echocardiography (TTE / TEE) – shows vegetations on valves, typically small and friable
- Blood cultures – negative (distinguishes from bacterial endocarditis)
- CT/MRI – if embolic complications suspected
- Coagulation profile – evaluate hypercoagulable state
- Underlying disease workup – malignancy or autoimmune disease
Diagnosis is challenging; high suspicion needed in chronically ill or cancer patients।
Marantic Endocarditis इलाज (Treatment of Marantic Endocarditis)
1. Treat Underlying Cause
- Cancer treatment (chemotherapy, surgery)
- Management of autoimmune disease (e.g., SLE therapy)
2. Anticoagulation
- Heparin or warfarin to prevent thrombus formation and embolization
- Regular monitoring of coagulation parameters
3. Supportive Care
- Monitor for embolic events
- Manage heart failure if valve function affected
- Nutritional support for wasting conditions
4. Surgical Intervention (Rare)
- Valve replacement if severe valvular dysfunction occurs
- Considered only if life-threatening complications arise
Early recognition and anticoagulation can prevent embolic complications।
रोकथाम (Prevention)
- Early diagnosis and management of underlying malignancy or autoimmune disease
- Prophylactic anticoagulation in high-risk patients
- Regular echocardiographic monitoring in patients with chronic disease
सावधानियाँ (Precautions)
- Monitor for sudden neurological deficits (stroke)
- Avoid trauma or procedures that increase embolic risk
- Adhere to anticoagulation regimen
- Promptly treat underlying systemic illness
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. क्या Marantic Endocarditis contagious है?
नहीं, यह non-infective, sterile thrombotic condition है।
Q2. क्या इसे antibiotics से treat किया जा सकता है?
नहीं, क्योंकि इसमें bacterial infection नहीं होती।
Q3. कौन high-risk में है?
Advanced cancer patients, chronic wasting illness, autoimmune disease वाले लोग।
Q4. Prognosis कैसा है?
Underlying disease और embolic complications पर निर्भर करता है। Early anticoagulation improves outcomes।
निष्कर्ष (Conclusion)
Marantic Endocarditis (मैरेंटिक एंडोकार्डिटिस) एक rare non-infective thrombotic valve disorder है, जो अक्सर cancer या chronic wasting disease में होती है।
Early detection, anticoagulation therapy, और underlying disease management से embolization और complications को prevent किया जा सकता है।
अगर किसी patient में stroke-like symptoms, fatigue, weight loss या heart murmur दिखे, तो echocardiography और specialist evaluation तुरंत जरूरी है।