Ultrasound Pictures “Endocarditis”

April 24, 2015 Posting Komentar

Clinical manifestations: significant general malaise

Diagnosis Ultrasound Pictures “Endocarditis”:
~ Known history of valvular heart disease. Do not overlook this diagnosis, especially in patients with artificial valves.
~ Repeated blood cultures; echocardiography; TEE
Sonographic findings:
~ Transthoracic echocardiography (TTE): valvular incompetence; thickened, echogenic valves, possibly with mobile vegetations (difficult to detect by TTE
because they are on the side away from the transducer)
~ Transesophageal echocardiography (TEE): thickened valves, echogenic mobile
vegetations on the valves. Aortic valve vegetations are usually on the aortic side, mitral valve vegetations are usually on the atrial side. It is rare to find
vegetations on the tricuspid valve (most common after catheterization and in
drug addicts) or pulmonary valve.
Accuracy of Ultrasound Pictures diagnosis “Endocarditis”: Valvular vegetations in endocarditis are clearly visualized by TEE but are easily mistaken for fibrotic or thrombotic deposits. A definitive diagnosis relies on multiple positive blood cultures. Follow-ups showing a regression of the changes in response to antibiotic therapy confirm the diagnosis.

“Ultrasound Pictures” Mitral valve endocarditis following a mitral valve replacement. he valve displays echogenic margins nd club-like expansion (arrow). Note he homogeneous, slightly echogenic nternal echo pattern (spontaneous choes) in the left atrium(LA) due to mitral nsufficiency. Fluttering motions of the ndocarditic vegetation can be seen with eal-time ultrasound. LV = left ventricle