Spectrum of echocardiographic findings in tricuspid valve endocarditis

This report describes a spectrum of M-mode and cross-sectional echocardiographic abnormalities in eight patients with infective endocarditis of the tricuspid valve. The M-mode echocardiogram of the tricuspid valve was abnormal in all but one patient in whom abnormal echoes were seen anterior to the tricuspid valve, in the right ventricular cavity and right ventricular outflow tract. Six patients had shaggy echoes on the tricuspid valve; and one patient showed multilayered echoes on the tricuspid valve which resembled a right atrial myxoma. Irregular diastolic fluttering of the tricuspid valve, indicative of ruptured chordae tendineae, was noted in three patients. The cross-sectional echocardiogram showed abnormal thick shaggy echoes on the tricuspid valve in all five patients on whom the procedure was performed. Contrast echocardiography confirmed the presence of tricuspid regurgitation in four patients. We conclude that echocardiography is useful in the diagnosis of tricuspid valve vegetations, and in detecting complications such as ruptured chordae tendineae and tricuspid regurgitation.