Does two-dimensional echocardiography improve the detection of vegetations compared to M-mode echocardiography in narcotic addicts with right-sided infective endocarditis?
Two-dimensional echocardiography offers distinct advantages over the standard M-mode technique in evaluating patients with right-sided infective endocarditis.
M-mode and two-dimensional echocardiograms were recorded in 12 narcotic addicts who had right-sided infective endocarditis. The two-dimensional echocardiogram showed vegetations in 10 patients (nine tricuspid and one pulmonic), while the M-mode echocardiogram was positive in six (five tricuspid and one pulmonic). The use of multiple transducer positions resulted in better visualization of the valves and appeared to be an important reason for the large number of positive two-dimensional echocardiograms. Echocardiographic findings were also available after completion of antibiotic therapy in seven of 10 patients. Of these seven patients, the vegetation appeared unchanged in three, diminished in size in three and was no longer visualized in one. No patient required valve replacement. Two-dimensional echocardiography using a wide-angle sector scanner appears to offer distinct advantages over the standard M-mode technique in evaluating patients with right-sided infective endocarditis.
Berger et al. (Tue,) studied this question.