What are the ultrasound findings of infective endocarditis?

Here, ultrasound refers to echocardiography. Echocardiographic findings in infective endocarditis may include vegetations, valvular damage, abnormal wall motion, perivalvular abscess, and changes in cardiac chamber size. If any abnormalities are detected, timely medical evaluation is recommended. Detailed explanations are as follows:

1. Vegetations

Vegetations are a characteristic feature of infective endocarditis. On echocardiography, they appear as irregular, solid echoes on the endocardial surface, which may attach to valve leaflets, chordae tendineae, or the inner heart wall. The size, shape, and location of vegetations can vary and may change over time. On ultrasound images, these vegetations typically appear as rice-grain-sized, mung-bean-sized, or polypoid abnormal echoes, which may be isoechoic or hyperechoic, often pedunculated, and move with the opening and closing of the valves.

2. Valvular Damage

Infective endocarditis commonly affects heart valves, causing local deformation or displacement of valve leaflets and restricted valve orifice opening, leading to valvular insufficiency or stenosis. Echocardiography clearly reveals morphological and functional changes in the valves, such as thickening, perforation, or prolapse. Among them, the aortic and mitral valves are most frequently involved.

3. Abnormal Wall Motion

Infective endocarditis may cause inflammatory reactions in the endocardium, resulting in focal or diffuse abnormalities in ventricular wall motion. Echocardiography can detect weakened or abnormal movement of the ventricular wall, which helps assess cardiac function.

4. Perivalvular Abscess

Severe infective endocarditis may be complicated by perivalvular abscess formation. Echocardiography can reveal fluid accumulation around the valve or pericardium, appearing as anechoic or hypoechoic regions with thick, irregular, and coarse-echoic walls.

5. Changes in Cardiac Chamber Size

Infective endocarditis may lead to alterations in cardiac chamber dimensions. For example, persistent infection may impair left ventricular function, leading to enlargement of the left atrium and left ventricle. Echocardiography allows measurement of chamber sizes, thereby helping evaluate cardiac function.

These findings assist physicians in accurately assessing the condition and formulating appropriate treatment plans. Treatment of infective endocarditis primarily includes antibiotic therapy—such as amoxicillin capsules, cefoxitin sodium for injection, and erythromycin tablets—as prescribed to eliminate the causative pathogens, and surgical intervention to remove infected tissue and repair cardiac structures.