heart and blood vessel disorders
Infective Endocarditis
Diagnosis of Infective Endocarditis
Echocardiography Blood cultures Because many of the symptoms are vague and general, doctors may have difficulty making a diagnosis. Usually, people suspected of having acute or subacute infective endocarditis are hospitalized promptly for diagnosis as well as treatment. Doctors may suspect endocarditis in people with a fever and no obvious source of infection, especially if they have Characteristic symptoms such as reddish spots on fingers or the whites of the eyes A heart valve disorder A replacement heart valve Recently had certain surgical, dental, or medical procedures Injected illicit drugs Development of a Physical Examination or a change in a preexisting heart murmur further supports the diagnosis. To help make the diagnosis, doctors usually do echocardiography and obtain blood samples to test for the presence of bacteria. Usually, three or more blood samples are taken at different times on the same day. These blood tests ( Culture of Microorganisms ) may identify the specific disease-causing bacteria and the best antibiotics to use against them. In people with heart abnormalities, doctors test their blood for bacteria before giving them antibiotics. Echocardiography and Other Ultrasound Procedures , which uses ultrasound waves, can produce images showing heart valve vegetations and damage to the heart. Typically, transthoracic echocardiography (a procedure in which the ultrasound probe is placed on the chest) is done. If this procedure does not provide enough information, the person may undergo transesophageal echocardiography (a procedure in which the ultrasound probe is passed down the throat into the esophagus just behind the heart). Transesophageal echocardiography is more accurate and detects smaller bacterial deposits, but it is invasive and more costly. Computed tomography (CT) is used occasionally when transesophageal echocardiography does not provide enough information. Positron emission tomography (PET) is sometimes used for the diagnosis of infective endocarditis of prosthetic heart valves and other devices placed in the heart. Sometimes bacteria cannot be cultured from blood samples. Special techniques may be needed to grow the particular bacteria, or the person may have taken antibiotics that did not cure the infection but did reduce the number of bacteria enough to be undetectable. Another possible explanation is that the person does not have endocarditis but has another condition, such as a Overview of Heart Tumors or 