Imaging for endocarditis: ESC10 and AHA4 recommendationsa
| Obtain echocardiography as soon as endocarditis is suspected |
| (ESC and AHA) |
| For initial investigation: |
| Transthoracic echocardiography (TTE) should be used (ESC) |
| Both TTE and transesophageal echocardiography (TEE) should be used (AHA) |
| Perform TEE: |
| If TTE is not diagnostic in patients with known or suspected infective endocarditis (ESC and AHA) |
| If complications are suspected (eg, new murmur, embolism, persisting fever, heart failure, abscess, atrioventricular block) (ESC and AHA) |
| If intracardiac device, leads, or prosthetic valves are present (ESC and AHA) |
| Repeat TEE if initial TTE is negative but clinical suspicion of infective endocarditis remains high: |
| 7-10 days later (ESC), or |
| 3-5 days later (AHA) |
↵a All recommendations listed are class 1 (strong).
AHA = American Heart Association; ESC = European Society of Cardiology