A negative transthoracic echocardiogram obviates the need for transesophageal echocardiography in patients with suspected native valve active infective endocarditis.

We studied 134 patients with suspected native valve infective endocarditis who underwent transthoracic and transesophageal echocardiography. Our data suggest that in patients without prosthetic valves who have a technically adequate negative transthoracic echocardiogram, transesophageal echocardiography is unlikely to be of incremental benefit in diagnosing endocarditis.