title: The diagnostic ability of echocardiography for infective endocarditis and its associated complications.
abstract: Echocardiography, transthoracic and transoesophageal, plays a key role in the diagnosis and prognosis assessment of patients with infective endocarditis. It constitutes a major Duke criterion and is pivotal in treatment guiding. Seven echocardiographic findings are major criteria in the diagnosis of infective endocarditis (IE) (vegetation, abscess, pseudoaneurysm, fistulae, new dehiscence of a prosthetic valve, perforation and valve aneurysm). Echocardiography must be performed as soon as endocarditis is suspected. Transoesophageal echocardiography should be done in most cases of left-sided endocarditis to better define the anatomic lesions and to rule out local complications. Transoesophageal echocardiography is not necessary in isolated right-sided native valve IE with good quality transthoracic examination and unequivocal echocardiographic findings. Echocardiography is a very useful tool to assess the prognosis of patients with IE at any time during the course of the disease. Echocardiographic predictors of poor outcome include presence of periannular complications, prosthetic dysfunction, low left ventricular ejection fraction, pulmonary hypertension and very large vegetations.
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Isidre
authors.initials: I
authors.lastname: Vilacosta
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Olmos
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: de Agustín
authors.affiliation: b 2 Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Fabián
authors.initials: F
authors.lastname: Islas
authors.affiliation: c 3 Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarriá
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ferrera
authors.affiliation: b 2 Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ortiz-Bautista
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sánchez-Enrique
authors.affiliation: a 1 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Vivas
authors.affiliation: b 2 Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: San Román
mesh_terms: D004452:Echocardiography / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis*; D006350:Heart Valve Prosthesis; D006801:Humans; D011379:Prognosis
keywords: diagnosis; echocardiography; infective endocarditis; periannular complications; prognosis; surgery; vegetation