Endocarditis (cont.)
How is endocarditis diagnosed?
The infection on the valve can cause build up of nodules on the valves called "vegetations". These valve vegetations can be detected by
echocardiography (an ultrasound examination of the heart). The most accurate method of detecting valve vegetations is with a procedure called transesophageal echocardiography (TEE). In this procedure an echo-transducer is placed on the tip of a flexible endoscope. The endoscope is inserted through the mouth into the esophagus. The transducer at the tip of the endoscope is then able to take sound wave "pictures" of the heart valves located adjacent to the lower esophagus. It is important to realize that endocarditis may exist without visible vegetations on the heart valve; the exact diagnosis is made by the identification of bacteria in a blood culture, in the appropriate clinical setting.
How is endocarditis treated?
The mainstay of treatment is aggressive antibiotics, generally given intravenously, usually for 4-6 weeks. The duration and intensity of treatment depends on the severity of the infection and the type of bacterial organism responsible. In cases where the valve has been severely damaged by the infection, resulting in severe valve dysfunction, surgical replacement of the valve may be necessary. Response to treatment is indicated by a reduction in fever, negative blood bacterial cultures, and findings on echocardiography.
Last Editorial Review: 7/9/2007
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