What imaging finding is most characteristic of endocarditis?

What imaging finding is most characteristic of endocarditis?

• A. Vegetation on heart valves on echocardiography
• B. Left ventricular dilation with reduced ejection fraction
• C. Pericardial effusion
• D. Pulmonary edema

Answer: (B)

A mass of infection and debris attached to a valve leaflet seen on echocardiography is the hallmark finding in endocarditis. These vegetations are mobile and friable, made of organisms enmeshed in thrombotic material, and they form on the valve surface where the infection begins. Echocardiography, especially transesophageal echocardiography, is the most sensitive imaging modality for spotting these vegetations and assessing related valve damage or new regurgitation. Other imaging findings listed—such as left ventricular dilation with reduced ejection fraction, pericardial effusion, or pulmonary edema—are not specific to endocarditis and reflect other cardiac or volume status issues rather than the characteristic infectious process on the valves. Vegetations on the valves on echo remain the best, most characteristic imaging clue for endocarditis.

A mass of infection and debris attached to a valve leaflet seen on echocardiography is the hallmark finding in endocarditis. These vegetations are mobile and friable, made of organisms enmeshed in thrombotic material, and they form on the valve surface where the infection begins. Echocardiography, especially transesophageal echocardiography, is the most sensitive imaging modality for spotting these vegetations and assessing related valve damage or new regurgitation.

Other imaging findings listed—such as left ventricular dilation with reduced ejection fraction, pericardial effusion, or pulmonary edema—are not specific to endocarditis and reflect other cardiac or volume status issues rather than the characteristic infectious process on the valves. Vegetations on the valves on echo remain the best, most characteristic imaging clue for endocarditis.