Luis Afonso1,2, Anupama Kottam3,4, Vivek Reddy4,5, Anirudh Penumetcha4,5. 1. Division of Cardiology, Wayne State University, Detroit, MI, USA. lafonso@med.wayne.edu. 2. Detroit Medical Center, Harper University Hospital, 3990 John R, 4 Hudson, Detroit, MI, 48201, USA. lafonso@med.wayne.edu. 3. Division of Cardiology, Wayne State University, Detroit, MI, USA. 4. Detroit Medical Center, Harper University Hospital, 3990 John R, 4 Hudson, Detroit, MI, 48201, USA. 5. Department of Internal Medicine, Wayne State University, Detroit Medical Center, Detroit, MI, USA.
Abstract
PURPOSE OF REVIEW: In this review, we examine the central role of echocardiography in the diagnosis, prognosis, and management of infective endocarditis (IE). RECENT FINDINGS: 2D transthoracic echocardiography (TTE) and transesophageal echocardiography TEE have complementary roles and are unequivocally the mainstay of diagnostic imaging in IE. The advent of 3D and multiplanar imaging have greatly enhanced the ability of the imager to evaluate cardiac structure and function. Technologic advances in 3D imaging allow for the reconstruction of realistic anatomic images that in turn have positively impacted IE-related surgical planning and intervention. CT and metabolic imaging appear to be emerging as promising ancillary diagnostic tools that could be deployed in select scenarios to circumvent some of the limitations of echocardiography. Our review summarizes the indispensable and central role of various echocardiographic modalities in the management of infective endocarditis. The complementary role of 2D TTE and TEE are discussed and areas where 3D TEE offers incremental value highlighted. An algorithm summarizing a contemporary approach to the workup of endocarditis is provided and major societal guidelines for timing of surgery are reviewed.
PURPOSE OF REVIEW: In this review, we examine the central role of echocardiography in the diagnosis, prognosis, and management of infective endocarditis (IE). RECENT FINDINGS: 2D transthoracic echocardiography (TTE) and transesophageal echocardiography TEE have complementary roles and are unequivocally the mainstay of diagnostic imaging in IE. The advent of 3D and multiplanar imaging have greatly enhanced the ability of the imager to evaluate cardiac structure and function. Technologic advances in 3D imaging allow for the reconstruction of realistic anatomic images that in turn have positively impacted IE-related surgical planning and intervention. CT and metabolic imaging appear to be emerging as promising ancillary diagnostic tools that could be deployed in select scenarios to circumvent some of the limitations of echocardiography. Our review summarizes the indispensable and central role of various echocardiographic modalities in the management of infective endocarditis. The complementary role of 2D TTE and TEE are discussed and areas where 3D TEE offers incremental value highlighted. An algorithm summarizing a contemporary approach to the workup of endocarditis is provided and major societal guidelines for timing of surgery are reviewed.
Entities:
Keywords:
2D TEE; 2D TTE; 3D TEE; Infective endocarditis
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