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Role of echocardiography in infective endocarditis

Nelson B Schiller, MD, FACC, FRCP, FASE
Bryan Ristow, MD, FACC, FASE, FACP
Xiushui Ren, MD
Section Editors
Warren J Manning, MD
William H Gaasch, MD
Deputy Editor
Brian C Downey, MD, FACC


Infection of the endocardium, or lining layer of the heart, can occur on any surface, including valve leaflets, congenital defects, the walls or chordae of the chambers, prosthetic tissue, or the attachment of implanted shunts, conduits, and fistulae. The clinical diagnosis of infective endocarditis (IE) is based upon a combination of features such as positive blood cultures, echocardiographic findings, and other clinical or laboratory criteria (table 1A-B) as specified in the modified Duke criteria [1]. (See "Clinical manifestations and evaluation of adults with suspected native valve endocarditis".)

The use of echocardiography in IE will be reviewed here, with emphasis on the clinical issues of its application and its potential weaknesses and pitfalls. The clinical diagnostic approach to this disorder is discussed separately. (See "Clinical manifestations and evaluation of adults with suspected native valve endocarditis".)


For patients undergoing echocardiography due to suspected infective endocarditis, the goals of the echocardiographic evaluation include:

Determining the underlying anatomy of the valvular structures (and comparing with prior studies, when available)

Determining the presence, location, size, and number of vegetations

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Literature review current through: Nov 2017. | This topic last updated: Jul 27, 2017.
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