Vegetations in infective endocarditis. Clinical relevance and diagnosis by cross sectional echocardiography.

W J Stafford, J Petch, D J Radford

Cross sectional echocardiography identified vegetations in 45 of 62 (73%) patients who had clinical evidence of active infective endocarditis. The sensitivity of this technique in diagnosing vegetations in infective endocarditis was 93% and the specificity 89%. The predictive value of a positive test was 96% and that of a negative test 80%. Vegetations were detected with a similar frequency on the aortic and mitral valves. The incidence of valvar incompetence, congestive heart failure, and the need for surgical intervention was similar in the patients with and without vegetations. Embolism occurred in 47% of those patients with vegetations and in 12% of those without. The mortality rate was 27% in those with vegetations, and no patient without vegetations died. Thus cross sectional echocardiography is accurate in diagnosing vegetations in patients with infective endocarditis, and this finding identifies patients at high risk of embolic complications and death.

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• Berkowitz, J. M., Lansman, S., Fyfe, B. (1998). Coronary Artery Mycotic Aneurysm Following Endocarditis of a Composite Aortic Graft: A Case Report and Literature Review. ANGIOLOGY 49: 145-150 [Abstract]  
• Lindner, J. R., Case, R. A., Dent, J. M., Abbott, R. D., Scheld, W. M., Kaul, S. (1996). Diagnostic Value of Echocardiography in Suspected Endocarditis : An Evaluation Based on the Pretest Probability of Disease. Circulation 93: 730-736 [Abstract] [Full Text]  
• Karban, A., Levy, Y., Markel, A., Torem, S., Brook, J. G. (1994). Aortoduodenal Fistula Associated with Streptococcus milleri Bacteremia and a Mitral Valve Vegetation: A Case Report. VASC ENDOVASCULAR SURG 28: 571-575 [Abstract]  
• Hecht, S. R., Berger, M. (1992). Right-sided Endocarditis in Intravenous Drug Users: Prognostic Features in 102 Episodes. ANN INTERN MED 117: 560-566 [Abstract]  
• Kinch, L. A., Bansal, R. C., de Lange, M. T. (1992). The Role of Echocardiography in Infective Endocarditis. Journal of Diagnostic Medical Sonography 8: 239-248 [Abstract]  
• Burger, A. J., Peart, B., Jabi, H., Touchon, R. C. (1991). The Role of Two-Dimensional Echocardiography in the Diagnosis of Ineffective Endocarditis. ANGIOLOGY 42: 552-560 [Abstract]  
• Cerebral Embolism Task Force, (1986). Cardiogenic Brain Embolism. Arch Neurol 43: 71-84 [Abstract]