Cardiovascular Imaging in Infective Endocarditis: A Multimodality Approach.

Area of Science:

• Cardiology
• Radiology
• Infectious Diseases

Background:

• Infective endocarditis (IE) presents significant morbidity and mortality.
• Diagnosis relies on modified Duke criteria, with echocardiography as the primary imaging tool.

Purpose of the Study:

• To review the modern approach to cardiac imaging in infective endocarditis.
• To discuss the role of multimodality imaging in evaluating native and prosthetic valve IE, and cardiac implantable electronic devices.

Main Methods:

• Echocardiography (transthoracic and transesophageal) for vegetation assessment and hemodynamic effects.
• Multidetector computed tomography (MDCT) and nuclear imaging (PET, WBC scintigraphy) for diagnostic uncertainty.
• Review of current guidelines and imaging utility for IE complications.

Main Results:

• Echocardiography effectively evaluates vegetation, paravalvular extension, and device infections.
• Advanced imaging (MDCT, nuclear) reduces misdiagnosis rates, particularly in complex IE cases.
• Imaging assesses local and distant IE complications like myocarditis and embolic events.

Conclusions:

• Multimodality imaging is essential for comprehensive IE evaluation and management.
• Advanced imaging techniques complement echocardiography, enhancing diagnostic accuracy for challenging IE cases.
• Imaging plays a vital role in assessing IE complications and guiding patient care.