In mural endocarditis the vegetations are formed directly on the endocardium of the atria or ventricles. The vegetations may or may not be in continuity with vegetations present in the valves or devices. In the image below the red vegetations are attached to the left atrial endocardium and can also be seen under the mitral valve. On microscopic examination they showed aspergillus fungal forms in a patient was immunocompromised by acute myelogenous leukemia.

Mural type vegetations can also be seen in the ventricular endocardium.