疑似感染性心内膜炎的诊断标准

Infective endocarditis can involve a normal, abnormal, or prosthetic cardiac valve. In recent years, infective endocarditis of normal right-sided valves has become more frequent as a consequence of intravenous (IV) injection of illicit drugs, indwelling IV catheters, and implantable cardiac devices . Although acute endocarditis of left-sided cardiac valves nearly invariably causes congestive heart failure, heart failure may also occur with subacute infective endocarditis. Physical examination typically reveals a new heart murmur. The diagnostic workup of patients with suspected infective endocarditis typically includes serial blood cultures and echocardiography.  

Infective endocarditis is fundamentally a clinical diagnosis based on the presence of positive blood cultures in association with characteristic symptoms and physical findings. Blood cultures may be negative in the setting of antibiotic use. Imaging is used to support the diagnosis by demonstrating vegetations of cardiac valves and, in complicated cases, paravalvular abscesses affecting native and prosthetic valves. Imaging is also used to assess the severity of valvular damage, identify complications, and recognize the presence and severity of heart failure.