Clinical Value of Transthoracic Echocardiography in the Diagnosis of Infective Endocarditis_West China Medical Journal

Authors：

 LUOKai-qin , XIAOJing , GUOMing-zhen , WANGLi-jie

Department of Ultrasound, the First People's Hospital of Guangyuan City, Guangyuan, Sichuan 628017, P. R. China;

Corresponding author：

Keywords：

Transthoracic echocardiography; Infective endocarditis; Vegetation; Clinical value

DOI：

10.7507/1002-0179.20150015

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Objective To explore the clinical value of transthoracic echocardiography (TTE) in the diagnosis of infective endocarditis. Methods We retrospectively analyzed the transthoracic echocardiogram in 35 patients with infective endocarditis confirmed between September 2003 and September 2013. Patients underwent routine heart scan in all sections to measure sizes of all chambers and cardiac function, observe morphologies, activities and functions of all valves and ventricular walls, and diagnose whether underlying heart diseases exist, focusing on intracardiac vegetations and their distributions, morphologies, sizes, numbers, echoes and activities, and a full analysis of the blood culture findings was also conducted. Results Of the 35 patients undergoing initial TTE, 29 were positive, and 6 were negative (2 positive and 4 negative in the reexamination one week later). Vegetations were found in the mitral valve (8/35), aortic valve (15/35), tricuspid valve (5/35), pulmonary valve (1/35), pulmonary arterial wall (1/35) and right ventricle (1/35), respectively. There were 29 (8 and 21 with congenital and acquired heart diseases, respectively) and 6 patients with and without underlying heart diseases, respectively. Of the 35 blood cultures, 33 were positive and 2 were negative. Conclusions TTE is rapid and accurate for early diagnosis of infective endocarditis, precise localization and rough quantification of vegetations, determination of whether valve damage occurs and what its severity is, and detection of whether complications exist. It is valuable for early diagnosis, treatment, follow-up and prognosis judgment.

Citation： LUOKai-qin, XIAOJing, GUOMing-zhen, WANGLi-jie. Clinical Value of Transthoracic Echocardiography in the Diagnosis of Infective Endocarditis. West China Medical Journal, 2015, 30(1): 56-59. doi: 10.7507/1002-0179.20150015 Copy

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12.	李治安.临床超声影像学[M].北京:人民卫生出版社, 2003:520.
13.	何锦霞.超声诊断感染性心内膜炎的临床价值[J].中国超声诊断杂志, 2004, 5(3):172-173.
14.	Le DY, Thuny F, Bastard E, et al. Images of cardiovascular medicine:pacemaker lead vegetation trapped in patent foramen ovale:a cause of hypoxemia after percutaneous extraction[J]. Circulation, 2009, 119(8):e223-e224.
15.	Jun DH, Nam CW, Cho YK, et al. Pulmonary emboli originating form infective endocarditis of the mitral valve migrating through an atrial septal defect[J]. Int J Cardiol, 2009, 133(1):e3-e5.

1. 李英, 张晓娟, 佃少娜, 等.感染性心内膜炎170例临床特点分析[J].实用医学杂志, 2012, 28(7):1142-1144.
2. 郁怡, 孙锟, 陈笋, 等.超声心动图诊断小儿感染性心内膜炎的临床应用价值[J].中华医学超声杂志:电子版, 2013, 10(8):633-638.
3. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association task fore on practice guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease):developed in collaboration with the society of cardiovascular anesthesiologists:endorsed by the society for cardiovascular angiography and interventions and the society of thoracic surgeons[J]. J Am Coll Cardiol, 2006, 48(3):e1-e148.
4. 龙世燕, 高明耀, 杨婕, 等.感染性心内膜炎伴深静脉血栓形成护理一例[J].华西医学, 2014, 29(10):1990-1991.
5. 侯江龙, 董力.心脏机械瓣膜置换术后的抗凝监测[J].华西医学, 2008, 23(3):643-644.
6. 罗天会, 曾玲.感染性心内膜炎合并右侧孤立肾换瓣术后护理[J].华西医学, 2014, 29(1):102-104.
7. Rostagno C, Rosso G, Puggelli FA, et al. Active infective endocarditis:clinical characteristics and factors related to hospital mortality[J]. Cardiol J, 2010, 17(6):566-573.
8. Sharma V, Candilio L, Hausenloy DJ. Infective endocarditis:anintensive care perspective[J]. Trends Anaesth Crit Care, 2012, 2(1):36-41.
9. Habib G, Hoen B, Tornos P, et al. Guidenlines on the prevention.diagnosis, and treatment of infective endocarditis (new version 2009):the task force on the prevention, diagnosis, and treatment of infective endocarditis of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2009, 30(19):2369-2413.
10. 王新房.超声心动图学[M]. 4版.北京:人民卫生出版社, 2009:371-378.
11. Baumgartner H, Bonhoeffer P, De Groot NM, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010)[J]. Eur Heart J, 2010, 31(23):2915-2957.
12. 李治安.临床超声影像学[M].北京:人民卫生出版社, 2003:520.
13. 何锦霞.超声诊断感染性心内膜炎的临床价值[J].中国超声诊断杂志, 2004, 5(3):172-173.
14. Le DY, Thuny F, Bastard E, et al. Images of cardiovascular medicine:pacemaker lead vegetation trapped in patent foramen ovale:a cause of hypoxemia after percutaneous extraction[J]. Circulation, 2009, 119(8):e223-e224.
15. Jun DH, Nam CW, Cho YK, et al. Pulmonary emboli originating form infective endocarditis of the mitral valve migrating through an atrial septal defect[J]. Int J Cardiol, 2009, 133(1):e3-e5.

West China Medical Journal

Clinical Value of Transthoracic Echocardiography in the Diagnosis of Infective Endocarditis

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