Echocardiography and Decision Making for Surgery

The diagnosis and management of patients with infective endocarditis (IE) can be a challenging. Because of the wide spectrum of presentations seen in IE, the current diagnostic approach incorporates clinical, pathological, serologic, and echocardiographic criteria into a strategy that maintains both sensitivity and specificity for this disease entity. This multimodality approach, in turn, leads to earlier diagnosis and therefore prompt implementation of appropriate therapies. Echocardiography remains the key imaging modality in diagnosing IE and its local complications. Knowing when to implement transthoracic echocardiography (TTE) versus transesophageal echocardiography (TEE) and recognizing key cardiac complications on echocardiography that warrant surgery is paramount to the successful management of patients with IE.