Yvorchuk K J, Chan K L
University of Ottawa Heart Institute, Ontario, Canada.
J Am Soc Echocardiogr. 1994 May-Jun;7(3 Pt 1):294-308. doi: 10.1016/s0894-7317(14)80400-8.
Infective endocarditis continues to be a cause of significant cardiac morbidity and mortality. To improve the prognosis of patients with this disorder, early diagnosis is crucial but difficult to establish on the basis of clinical parameters alone. Echocardiography, both transthoracic and transesophageal techniques, has a major role in the detection of vegetations that are the hallmark of endocarditis. Valvular and perivalvular complications can also be well assessed by echocardiography. With the improved resolution provided by recent technologic advances in echocardiography, vegetations can be reliably detected in most patients with endocarditis. We propose that present diagnostic criteria for endocarditis be revised to include echocardiographic findings as a major parameter in the diagnosis. Finally, a diagnostic approach incorporating transthoracic and transesophageal echocardiography in these patients will be discussed taking into consideration the different degrees of clinical suspicion for the existence of the disease.
感染性心内膜炎仍然是导致严重心脏发病和死亡的原因之一。为改善患有这种疾病患者的预后，早期诊断至关重要，但仅基于临床参数很难确立诊断。经胸和经食管超声心动图技术在检测作为心内膜炎标志的赘生物方面发挥着主要作用。瓣膜及瓣周并发症也可通过超声心动图得到很好的评估。随着超声心动图技术的最新进展提供了更高的分辨率，大多数心内膜炎患者的赘生物能够被可靠地检测到。我们建议修订目前的心内膜炎诊断标准，将超声心动图检查结果作为诊断的主要参数纳入其中。最后，将结合经胸和经食管超声心动图，针对这些患者不同程度的临床疾病怀疑情况，讨论一种诊断方法。
