Circulation, Vol 53, 474-482, Copyright © 1976 by American Heart Association
P Roy, AJ Tajik, ER Giuliani, TT Schattenberg, GT Gau and RL Frye
Forty-seven echocardiograms were obtained in 32 patients with bacterial
endocarditis. Preexistent abnormalities were found in 14 patients. In five
of them thought to have bacterial endocarditis on normal valves,
echocardiography showed mitral stenosis (one), bicuspid aortic valve (two),
and prolapse of mitral valve (two). Definite vegetations were seen in 22
patients--on the aortic valve in seven, the mitral valve in 12, and both
valves in three. Ten patients had milder changes suggestive but not
diagnostic of vegetations. In 12 patients, surgery confirmed the
echocardiographic findings. Fourteen had systemic embolic episodes and all
had echocardiographic evidence of vegetations. Abnormalities secondary to
bacterial endocarditis, other than vegetations, were common. Twenty-one
patients had left ventricular volume overload. Ten had a flail posterior
leaflet of the mitral valve, three of which were confirmed surgically.
Eight had abnormal coarsely fluttering echoes in the left ventricular
outflow tract consistent with a prolapsing aortic valve or underlying
aortic vegetations; four were confirmed by surgery. Five had signs of
severe aortic regurgitation of recent onset (premature mitral valve
closure) and all had confirmation by surgery. Echocardiographic
abnormalities persisted after successful medical treatment. We conclude
that echocardiography is helpful in patients with bacterial endocarditis.
It permits recognition of unsuspected preexistent lesions and the
characteristic vegetations, as well as the extent and nature of valvular
damage secondary to bacterial endocarditis. However, echocardiography does
not differentiate between active and healed lesions.
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Spectrum of echocardiographic findings in bacterial endocarditis
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