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Tricuspid valve endocarditis: Cardiovascular imaging evaluation and management
1Section of Cardiovascular Imaging, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, United States.
World Journal of Clinical Cases
|November 17, 2021
Summary
Right-sided infective endocarditis (IE), often affecting the tricuspid valve, is increasingly diagnosed. Multimodality imaging aids in diagnosing IE and its complications, guiding patient management.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Right-sided infective endocarditis (IE), particularly tricuspid valve endocarditis (TVIE), is a growing clinical concern.
- Intravenous drug use, cardiac implantable electronic devices, and indwelling catheters are key risk factors for TVIE.
- Staphylococcus aureus is the most common pathogen identified in TVIE cases.
Purpose of the Study:
- This review provides an updated overview of tricuspid valve endocarditis (TVIE).
- It discusses the critical role of multimodality imaging in diagnosing and managing TVIE.
- The review also covers current patient management strategies for TVIE.
Main Methods:
- Diagnosis of IE relies on clinical presentation, blood cultures, and echocardiography.
- Advanced imaging techniques, including multislice computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography/CT, and radiolabeled white blood cell single-photon emission computed tomography (SPECT), are employed.
- These methods aid in detecting extra-cardiac complications like pulmonary septic emboli and IE in prosthetic valves or devices.
Main Results:
- Echocardiography is the primary diagnostic tool for valvular vegetations in IE.
- Complementary imaging is essential when initial echocardiography is inconclusive despite high clinical suspicion.
- Advanced imaging modalities offer valuable insights into IE extent and complications, especially in complex cases involving devices or prosthetic valves.
Conclusions:
- Multimodality imaging significantly enhances the diagnostic accuracy of TVIE and its complications.
- Effective management of TVIE involves a combination of appropriate diagnostic imaging and tailored therapeutic strategies.
- Continued research and updates on TVIE diagnosis and management are crucial for improving patient outcomes.
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