Echocardiography in Infective Endocarditis Diagnosis

Abstract

Echocardiography plays a key in the diagnosis of IE, in the prognostic, assessment and in the follow-up under therapy. Any patient suspected of having infective endocarditis by clinical criteria should be screened by TTE. When the images are of good quality and the study is negative, an alternative diagnosis should be sought, if the clinical suspicion is low. If the clinical suspicion is high, TOE should be performed. TOE should also be performed if the results of TTE are equivocal owing to underlying structural abnormalities or poor acoustic windows. If TOE is negative, observation or re-evaluation of the clinical data is warranted. If the suspicion of endocarditis is high, TOE should be repeated after 7 to 10 days to allow potential vegetations to become more apparent. TOE should also be performed to provide a more detailed anatomical assessment when perivalvular complications are suspected particularly in the setting of aortic or prosthetic valve endocarditis or in infections caused by virulent microorganisms such as S aureus.