title: Noninvasive methods for detection of valve vegetations in infective endocarditis.
abstract: To determine the optimal noninvasive method for the demonstration of endocarditic vegetations, 35 consecutive episodes of clinically diagnosed endocarditis in 33 patients were studied with M mode and two dimensional echocardiography, and with gallium-67 citrate and technetium-99m stannous pyrophosphate cardiac scanning. Clinical criteria for the diagnosis of endocarditis were: temperature higher than 38 degrees C; sustained bacteremia with at least three positive blood cultures; no extracardiac focus of bacteremia; and known underlying heart disease, a new or changing murmur or a history of intravenous drug abuse with radiologic evidence of septic pulmonary emboli. M mode echocardiography detected 18 vegetations in 17 of the 35 episodes of endocarditis studied (49 percent positive); two dimensional echocardiography detected 30 vegetations in 28 of the 35 episodes studied (80 percent positive). In contrast, no vegetations were detected with technetium-99m stannous pyrophosphate scanning,, and only two gallium-67 citrate scans were positive. The advantage of the two dimensional echocardiographic technique over all others tested was particularly notable for the identification of aortic and tricuspid valve vegetations.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging