Two dimensional echocardiography and cardiac Doppler should ideally be performed on all patients suspected of having infective endocarditis. These investigations allow for diagnosis and evaluation of valve lesions, enabling the haemodynamic consequences of lesions to be assessed and the identification of complications such as an aortic root abscess or ruptured chordae tendinae. Echocardiography may help identify those patients in need of urgent surgery.
Small valvular vegetations may however be missed and a negative result does not exclude endocarditis. In these cases transoesophageal echo may provide a better view, and it is the technique of choice when prosthetic valve lesions are suspected.
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