Value of Transesophageal Echocardiography as an Adjunct to Transthoracic Echocardiography in Evaluation of Native and Prosthetic Valve Endocarditis (1)Infectious endocarditis is a diagnosis that is frequently entertained. If confirmed, it carries a significant morbidity and mortality. Clinical presentation of this disease is often vague and easily attributable to a host of other causes. Common laboratory abnormalities such as leukocytosis and positive blood cultures, while supportive of the diagnosis of infectious endocarditis, are nonspecific. Transthoracic echocardiography has been the traditional diagnostic modality used for documenting vegetations when infectious endocarditis is suspected. However, technical limitations with this imaging technique will sometimes impair visualization of key structures and associated abnormalities. antibiotics levaquin
Recent data suggest that transesophageal echocardiography may be a valuable adjunct to conventional transthoracic echocardiography for evaluation of valvular and paravalvular lesions. The esophagus provides a readily accessible conduit for placement of an ultrasonic transducer adjacent to the left atrium and in close proximity to other cardiac structures. Furthermore, because only the esophageal wall and supportive tissues are interposed between the transducer and the heart, a higher-frequency transducer may be used, thereby enhancing resolution and image quality. Transesophageal echocardiography may be particularly useful in specific cases such as prosthetic valve endocarditis where images are otherwise obstructed by a valve prosthesis on the precordial examination.