Embolic risk in subacute bacterial endocarditis: determinants and role of transesophageal echocardiography

Abstract

Embolic events are a frequent and life-threatening complication of subacute bacterial endocarditis (SBE), and are associated with a high mortality and morbidity. The prediction of the embolic risk in an individual patient remains a challenge. Echocardiography plays a key role in the management of infective endocarditis both for the diagnostic and prognostic assessment of these patients, but its value in predicting embolic events is still debated. This review focuses on the characteristics of embolic events in SBE, and on the role of echocardiography, especially transesophageal echocardiography (TEE), in the prediction of embolic events. The review confirms that, among other factors, TEE may be helpful in both the prediction of the embolic risk, and the decision to perform early surgery.