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Serial echocardiographic appearance of healing bacterial vegetations

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Abstract

Serial M mode and cross-sectional echocardiograms were obtained from six patients who had been treated with antibiotic drugs for infectious endocarditis. Three to six M mode echocardiograms and one to six cross-sectional echocardiograms were obtained from each patient over a follow-up period averaging 50 weeks (range 10 to 108 weeks). On echocardiography, vegetations were observed to have become smaller and more echo-reflective with healing. A dramatic change was seen in two patients after peripheral embolization. M mode echocardiography was particularly helpful in determining the quality of echo reflection by vegetations; cross-sectional echocardiography was more helpful in judging the size and shape of a vegetation. Echocardiography is ideally suited for the serial visualization of healing vegetations in patients who do not require early valve replacement. It may prove helpful to examine serially valve vegetations with both M mode and cross-sectional echocardiography when following up patients with infectious endocarditis treated with antibiotic agents.

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This study was supported in part by grants from the Herman C. Krannert Fund, Indianapolis, Indiana, Grants HL-06308 and HL-05749 from the U.S. Public Health Service, National Heart, Lung, and Blood Institute, Bethesda, Maryland, the American Heart Association, Indiana Affiliate, Inc., Indianapolis, Indiana, and the Veterans Administration, Washington, D.C.

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