Doppler Echo

The next laboratory test that should be obtained is an echo Doppler to document the presence and size of any vegetation, the degree of mitral regurgitation, the presence and type of complications and associated lesions and left ventricular function.

Echocardiography is commonly used to visualize the vegetations. The absence of a vegetation on transthoracic echocardiography, or TTE, however, does not rule out endocarditis, as its sensitivity is only sixty to sixty-five percent. Seeing a mass typical of a vegetation in the appropriate clinical setting, however, is ninety to ninety-five percent predictive of the presence of endocarditis. Transesophageal echocardiography, or TEE, improves the sensitivity for visualization of a vegetation to over nienty-five percent. The procedure is associated with very little risk. Serial echo-Doppler studies during the course of the illness, are valuable to assess the extent of valvular damage and complications and to assist in determining necessity for and timing of surgery.