Perivalvular Complication in Infective Endocarditis: An Integrated Imaging Approach in the Diagnostic Workup

Area of Science:

• Cardiology
• Medical Imaging
• Infectious Diseases

Background:

• Infective endocarditis (IE) is a serious condition with significant morbidity and mortality.
• Current guidelines emphasize imaging for IE diagnosis, with echocardiography as the primary tool.
• Limitations in initial echocardiography may necessitate advanced imaging techniques.

Purpose of the Study:

• To review the role of cardiac imaging in evaluating infective endocarditis.
• To specifically assess the utility of transesophageal echocardiography (TEE) and cardiac computed tomography (CT) in diagnosing IE perivalvular complications.

Main Methods:

• Review of current literature and guidelines regarding cardiac imaging in IE.
• Focus on the diagnostic capabilities of transthoracic echocardiography (TTE), TEE, and cardiac CT.
• Evaluation of imaging for assessing IE lesions and associated cardiac complications.

Main Results:

• Echocardiography is the first-line diagnostic imaging modality for IE.
• Transesophageal echocardiography (TEE) is essential for inconclusive or suspected IE cases and for detailing complications.
• Cardiac CT and nuclear imaging aid in confirming diagnosis, characterizing lesions, and identifying cardiac complications.

Conclusions:

• Cardiac imaging, particularly TEE and cardiac CT, plays a vital role in the comprehensive evaluation of infective endocarditis.
• These advanced imaging modalities are crucial for diagnosing and managing IE-related perivalvular complications.
• Multimodality imaging approaches enhance diagnostic accuracy and patient management in IE.