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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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.臨床超聲影像學[M].北京:人民衛生出版社, 2003:520.
13.	何錦霞.超聲診斷感染性心內膜炎的臨床價值[J].中國超聲診斷雜志, 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, 張曉娟, 佃少娜, 等.感染性心內膜炎170例臨床特點分析[J].實用醫學雜志, 2012, 28(7):1142-1144.
2. 郁怡, 孫錕, 陳筍, 等.超聲心動圖診斷小兒感染性心內膜炎的臨床應用價值[J].中華醫學超聲雜志:電子版, 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. 龍世燕, 高明耀, 楊婕, 等.感染性心內膜炎伴深靜脈血栓形成護理一例[J].華西醫學, 2014, 29(10):1990-1991.
5. 侯江龍, 董力.心臟機械瓣膜置換術后的抗凝監測[J].華西醫學, 2008, 23(3):643-644.
6. 羅天會, 曾玲.感染性心內膜炎合并右側孤立腎換瓣術后護理[J].華西醫學, 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.超聲心動圖學[M]. 4版.北京:人民衛生出版社, 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.臨床超聲影像學[M].北京:人民衛生出版社, 2003:520.
13. 何錦霞.超聲診斷感染性心內膜炎的臨床價值[J].中國超聲診斷雜志, 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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