"Echocardiography is the primary imaging modality of cardiac infections. It has been integrated into the Duke criteria for diagnosis of infective endocarditis. Transoesophageal echocardiography is superior to transthoracic investigations; the latter should only be used as a screening modality in low-risk patients with a low pre-test probability/clinical suspicion 9."
"Cardiac MRI can detect valvular vegetation features of infective endocarditis. The appearance of vegetations depends on the imaging sequence used and ranges from low to intermediate signal intensity and isointense to muscle with balanced steady-state free precession (SSFP) and inversion-recovery sequences. Post-gadolinium images may show enhancement of the vegetations and abscess. In the absence of vegetations, MRI can demonstrate delayed enhancement representing endothelial inflammation of the cardiovascular structures, which can contribute to the diagnosis and treatment planning of infective endocarditis 2. Cardiac MR imaging also allows quantification of regurgitation fraction."
"prolongation of the PR interval"
"with progressive degrees of AV block"
"voltage criteria for hypertrophy with regional ST depression and T wave inversion"
"Lambl’s excrescence"
Expected headings
"ECG"
"Echocardiography"
"Complications"
"may be secondary to conduction system invasion or underlying predisposition (e.g. aortic stenosis)"
"Once the endocarditic lesion is initiated, the clotting pathway catalyses vegetation formation. The microbes become buried in the vegetation and may form a biofilm around them, thereby becoming inaccessible to immune cells or antibiotic drugs for clearance and eradication. Endocarditic vegetation is the pathologic hallmark of infective endocarditis and commonly appears as an irregular, mobile or fixed mass and is usually attached to the endocardium on the low-pressure side of a valve, chordae tendineae or ascending aorta. Vegetation fragments can break off and undergo embolisation, causing more conspicuous clinical signs and symptoms of infection like pneumonia and stroke."
"paravalvular, annular or aortic abscess / aortic root abscess"
"Echocardiography is the primary imaging modality of cardiac infections. It has been integrated into the Duke criteria for diagnosis of infective endocarditis. Transoesophageal echocardiography is superior to transthoracic investigations; the latter should only be used as a screening modality in low-risk patients with a low pre-test probability/clinical suspicion 9."