Journal article
Clinical criteria and the appropriate use of transthoracic echocardiography for the exclusion of infective endocarditis
Heart, Vol.89(3), pp.273-275
2003
Abstract
Background: Clinical guidelines currently suggest that transthoracic echocardiography (TTE) be carried out in all patients with suspected endocarditis, but the use of TTE where there is a low probability of infective endocarditis has a poor diagnostic yield. This screening approach may no longer be appropriate. Objective: To examine whether clinical criteria might aid decision making with respect to the use of TTE in possible endocarditis. Design: A retrospective review of patient records. Setting: Cardiology department of a tertiary referral centre. Patients: 500 consecutive hospital inpatients referred for TTE to exclude endocarditis. Main outcome measures: Evidence of endocardial vegetations on TTE and the presence of predetermined clinical criteria that may predispose to, or be suggestive of, endocarditis. Results: Evidence of infective endocarditis was detected on echocardiography in 43 of the 500 patients (8.6%). In 239 patients (48%), vegetations and certain prespecified clinical criteria were both absent. These criteria were: vasculitic/embolic phenomena; the presence of central venous access; a recent history of injected drug use; presence of a prosthetic valve; and positive blood cultures. The collective absence of these five criteria indicated a zero probability of TTE showing evidence of endocarditis. Conclusions: The use of simple clinical criteria during the decision making process may avoid many unnecessary TTE examinations in hospital inpatients with a low probability of endocarditis.
Details
- Title
- Clinical criteria and the appropriate use of transthoracic echocardiography for the exclusion of infective endocarditis
- Authors
- Kim Greaves (Author) - Royal Prince Alfred HospitalD Mou (Author) - Royal Prince Alfred HospitalA Patel (Author) - Royal Prince Alfred HospitalD S Celermajer (Author) - Royal Prince Alfred Hospital
- Publication details
- Heart, Vol.89(3), pp.273-275
- Publisher
- B M J Group
- Date published
- 2003
- DOI
- 10.1136/heart.89.3.273
- ISSN
- 1355-6037
- Organisation Unit
- Faculty of Science, Health, Education and Engineering; University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99449301402621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Cardiac & Cardiovascular Systems
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Source: InCites