Diagnostic Approach to Endocarditis

Infective endocarditis is a challenging disorder to diagnose. Thorough assessment with history, physical examination, microbiology, blood cultures and the thoughtful application of cardiac imaging, incorporating the concepts of pretest likelihood and clinical utility, will assist in this diagnostic dilemma. Patients with unexplained Staphylococcus aureus bacteremia, prosthetic heart valve or intracardiac electrical devices produce additional challenges. The timing and usefulness of transthoracic echocardiography, transesophageal echocardiography and positron emission tomography will be presented.