Infective Endocarditis

Question 1

High risk echo findings endocarditis

Answer 1

Large mobile vegetation
Prosthetic valve
Perivalvular extension
Grade III-IV regurgitation (perforation, flail, dehiscence)
New LV dysfunction

Question 2

Motion characteristics endocarditis

Answer 2

Oscillating mass

Independent motion

Question 3

Echo effects endocarditis

Answer 3

New regurgitation
Abscess, sinus or fistula formation
Prosthetic dehiscence

Question 4

Echo location endocarditis

Answer 4

Upstream side of valve in path of regurgitant jet or on prosthetic material
Mitral - LA
Aortic - LV

Question 5

Echo shape endocarditis

Answer 5

Lobulated, amorphous

Question 6

Clues for aortic root abscess

Answer 6

First degree AV block
Pericardial effusion
Thickening of aortic annulus > 4 mm
Echolucency 
Vegetation at valve annulus rather than leaflet tip

Question 7

Pseudoaneurysm

Answer 7

Pulsatile, perivavular echo-free space with color doppler flow detected

Question 8

Fistula

Answer 8

Hole, communication of color doppler between 2 cavities

Question 9

Gerbode defect

Answer 9

LV to RA fistula

Continuous doppler signal

Question 10

Prosthetic dehiscence

Answer 10

Perivalvular regurgitation with or without rocking motion of prosthesis

Question 11

Embolic event echo predictors

Answer 11

> 10 mm
Highly mobile
Anterior mitral leaflet

Question 12

Prosthetic valve organism < 2 mo

Answer 12

CNS

staph auerus

Question 13

Prosthetic valve organism > 1 yr

Answer 13

Strep viridans

Staph aureus

Question 14

Most common vegetation with VSD

Answer 14

TV septal leaflet

Question 15

Most likely to be confused for MV abscess

Answer 15

Casseous calcification of mitral annulus

Question 16

% of valves that retain normal function after vegetation resolves

Answer 16

<10%

Question 17

Eustachian valve vegetation

Answer 17

Thickness >5mm

Independent motion

Question 18

Mitral valve aneurysm characteristics

Answer 18

Localized bulging of mitral leaflet towards LA with systolic expansion and diastolic collapse

Question 19

A ghost

Answer 19

Tubular, mobile mass in path of intracardiac lead after lead extraction for infection