Editing Infective endocarditis (section)

===Ultrasound===
[[Echocardiography]] is the main type of diagnostic imaging used to establish the diagnosis of infective endocarditis.<ref name="Hubers2020"/> There are two main types of echocardiography used to assist with the diagnosis of IE: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE).<ref name="Hubers2020"/>

The transthoracic echocardiogram has a sensitivity and specificity of approximately 65% and 95% if the echocardiographer believes there is 'probable' or 'almost certain' evidence of endocarditis.<ref name="Shively">{{cite journal | vauthors = Shively BK, Gurule FT, Roldan CA, Leggett JH, Schiller NB | title = Diagnostic value of transesophageal compared with transthoracic echocardiography in infective endocarditis | journal = Journal of the American College of Cardiology | volume = 18 | issue = 2 | pages = 391–7 | date = August 1991 | pmid = 1856406 | doi = 10.1016/0735-1097(91)90591-V | doi-access = free }}</ref><ref name="Erbel">{{cite journal | vauthors = Erbel R, Rohmann S, Drexler M, Mohr-Kahaly S, Gerharz CD, Iversen S, Oelert H, Meyer J | title = Improved diagnostic value of echocardiography in patients with infective endocarditis by transoesophageal approach. A prospective study | journal = European Heart Journal | volume = 9 | issue = 1 | pages = 43–53 | date = January 1988 | pmid = 3345769 | doi=10.1093/oxfordjournals.eurheartj.a062389}}</ref> However, in endocarditis involving a prosthetic valve, TTE has a sensitivity of approximately 50%, whereas TEE has a sensitivity exceeding 90%.<ref name="Hubers2020" /> The TEE also has an important diagnostic role when the TTE does not reveal IE but diagnostic suspicion remains high,  since TEE is more sensitive for infective endocarditis and is better able to characterize infection-related damage to the heart valves and surrounding tissues.<ref name="Hubers2020" />

Guidelines support the initial use of TTE over TEE in people with abnormal blood cultures, a new heart murmur, and suspected infective endocarditis.<ref name="Hubers2020" /> TEE is the preferred initial form of imaging in people with suspected infective endocarditis who have a moderate to high pretest probability of infective endocarditis, including people with prosthetic heart valves, blood cultures growing ''[[Staphylococcus]]'',  or have an intracardiac device (such as a [[pacemaker]]).<ref name="Hubers2020" />

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File:UOTW 27 - Ultrasound of the Week 1.webm|Ultrasound showing infectious endocarditis<ref name=UOTW27>{{cite web|title=UOTW #27 – Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-27/|website=Ultrasound of the Week|access-date=27 May 2017|date=26 November 2014|url-status=live|archive-url=https://web.archive.org/web/20170509110315/https://www.ultrasoundoftheweek.com/uotw-27/|archive-date=9 May 2017}}</ref>
File:UOTW 27 - Ultrasound of the Week 2.webm|Ultrasound showing infectious endocarditis<ref name=UOTW27/>
File:UOTW 27 - Ultrasound of the Week 3.webm|Ultrasound showing infectious endocarditis<ref name=UOTW27/>
File:UOTW 60 - Ultrasound of the Week 1.webm|Ultrasound showing another case of infectious endocarditis<ref>{{cite web|title=UOTW #60 – Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-60/|website=Ultrasound of the Week|access-date=27 May 2017|date=5 October 2015|url-status=live|archive-url=https://web.archive.org/web/20170509150141/https://www.ultrasoundoftheweek.com/uotw-60/|archive-date=9 May 2017}}</ref>
</gallery>