Echocardiographic documentation of vegetative lesions in infective endocarditis: clinical implications.

Journal Article

Eighty-seven patients with the clinical syndrome of infective endocarditis were examined by M-mode and two-dimensional echocardiography. Patients were divided into two groups based on the presence or absence of echocardiographically detected vegetative lesions. Group 1 consisted of 47 patients with one or more vegetations. Group 2 consisted of 40 patients without evidence of vegetations. Group 1 patients had a higher rate of complications: emboli, congestive heart failure and the need for surgical intervention. Analysis of morphologic characteristics of the vegetations in group 1 was of no predictive value for complications in individual patients. Two-thirds of the vegetations persisted unaltered well beyond the period of bacteriologic cure without significant complications. No characteristic alteration of the vegetations predicted the efficacy of medical therapy. Although the detection of vegetations by echocardiography in patients with the clinical syndrome of endocarditis clearly identifies a subgroup at risk for complications, decisions regarding clinical management made solely on the basis of the presence or absence of vegetative lesions are hazardous. Management of such patients must continue to be based on the clinical integration of multiple factors.

Full Text

Duke Authors

Cited Authors

  • Stewart, JA; Silimperi, D; Harris, P; Wise, NK; Fraker, TD; Kisslo, JA

Published Date

  • February 1, 1980

Published In

Volume / Issue

  • 61 / 2

Start / End Page

  • 374 - 380

PubMed ID

  • 7351063

International Standard Serial Number (ISSN)

  • 0009-7322

Language

  • eng

Conference Location

  • United States