Ultrasonographic examination enables the detection of vegetations, valvular regurgitation, intramyocardial abscesses, and subaortic complications in patients with suspected endocarditis, but the role echocardiography should play in the diagnosis and management of patients with suspected IE is still somewhat unclear. Echocardiography is useful when the clinical suspicion of IE is intermediate or high but of little value in individuals in whom the suspicion is low. In patients with known endocarditis, echocardiography may provide information important to optimal management. TEE is generally superior to TTE, especially in patients with prosthetic valves, in the detection of abscess formation, and in those patients in whom TTE is either inadequate or indicates an intermediate probability of endocarditis. Despite recent advances in our understanding of the role echocardiography should play in patients with known or suspected IE, there remain many unanswered questions and it should be emphasized that echocardiographic data must be interpreted in conjunction with clinical information.
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