Management of infective endocarditis using echocardiography.

Serial echocardiograms of five children who had infective endocarditis were analyzed and correlated with the clinical course. Vegetations were visualized initially on M-mode in four and on two-dimensional echocardiograms in all patients. The appearance of the vegetation was unexpected in one. More accurate anatomic localization of the vegetation was possible using two-dimensional echography. Four of the five patients died despite vigorous medical treatment and valve replacement in two. Complete resolution of the vegetation was documented for the first time in a child following medical therapy. This study suggests that echocardiography plays an important role in the diagnosis of endocarditis, allows objective follow-up of the size of the vegetations and their effects on valve function, and, therefore, may prove helpful in the management of these patients.