Diagnostic evaluation of myocardial abscesses. A new look at an old problem.

A myocardial abscess is a life threatening complication of infective endocarditis that necessitates early diagnosis in order to identify the need for emergent surgical intervention and improved prognosis. This review discusses the relevant historical aspects, clinical features suggestive of the diagnosis, associated conditions and various appropriate imaging modalities--in particular, trans-thoracic and trans-esophageal echocardiography, Indium-111 radionucleide scintigraphy, and computerized tomographic scanning. Specific clinical and echocardiographic criteria for identifying a myocardial abscess are discussed and comparative data presented from published studies in the literature.