March 3, 2026Open Access

Unexpected Infective Endocarditis Presenting With Multiple Pulmonary Emboli Despite Negative High-Risk Imaging

Key Points

Pulmonary emboli were found in a patient with infective endocarditis despite negative cardiac imaging results.
In this case, both transthoracic and transesophageal echocardiography did not reveal typical signs of infective endocarditis.
The case highlights the potential for poor imaging results in diagnosing infective endocarditis, even with significant complications.
Findings call for increased awareness of infective endocarditis presentations that may not conform to typical imaging expectations.

Abstract

Infective endocarditis (IE) is notorious for causing septic emboli in major organs, especially the brain, spleen, and lungs. These emboli are expected to be caused by the shedding of vegetations that form on the endocardium of the heart. Therefore, positive findings of IE are generally expected on cardiac imaging, such as transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), when septic emboli are identified in a high-risk patient. This case highlights negative TTE and TEE findings in a patient with infective endocarditis who had an extensive burden of bilateral, multiple pulmonary emboli.

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Cite This Study

Nyan Lin Myint (Mon,) studied this question.

synapsesocial.com/papers/69a76628badf0bb9e87dbe94 https://doi.org/https://doi.org/10.7759/cureus.102844

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