Echocardiographic evaluation of a patient with suspected infective endocarditis

General approach for diagnosis of infective endocarditis by echocardiography. Individual patient circumstances may justify different approaches. Please note that for well visualized uncomplicated tricuspid or pulmonic endocarditis, a transesophageal echocardiogram may not be necessary.

TTE: transthoracic echocardiogram; TEE: transesophageal echocardiogram; AV: atrioventricular.
* High clinical suspicion includes previous infective endocarditis, worsening valvular regurgitation, recurrent unexplained bacteremia, embolic events, or AV heart block.
¶ Moderate clinical suspicion includes Duke criteria "possible endocarditis" or scenarios where an alternative infectious source may not usually cause bacteremia.

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Echocardiographic evaluation of a patient with suspected infective endocarditis