Spectrum of Echocardiographic Findings in Bacterial Endocarditis
Forty-six echocardiograms were obtained from 32 patients with bacterial endocarditis (BE), using a commercially available, single probe instrument (Ekoline Model 20) interfaced on a strip chart recorder (Honeywell Model 1856 or Cambridge Multichannel Physiological Recorder). A 2.25-MHz , 1/2-inch-diameter, 5.0- or 7.5-cm focused transducer was used. The group included 23 males (72%) and 9 females (28%) with an average age of 53 years. Twentynine patients (91%) had active BE, whereas 3 were referred for valve replacement after successful medical treatment. All had endocarditis on natural valves. No patient was included whose clinical findings could be explained entirely by sustained bacteremia without cardiac involvement. Twenty-nine patients (91%) had consistently positive blood cultures and 29 (91%) had congestive heart failure. Fourteen patients (44%) had systemic embolic episodes. Nineteen patients (59%) had surgical interventions related to their BE: 5 had embolectomy and 14 had valve replacement. In two cases, autopsy was performed. The echocardiograms were interpreted without knowledge of surgical or autopsy findings. Correlation was good between echocardiographic and anatomic observations.