How is cardiovascular infection diagnosed?

Dennis W. Kim, MD
Pediatric Cardiology
Bacterial infections of the heart structures, also known as endocarditis, can sometimes be hard to diagnose. Most commonly, endocarditis is confirmed by by repeated cultures of the blood that reveal the culprit organism. If the areas of infection in the heart are large enough, these so called "vegetations" can sometimes be seen by an ultrasound test called an echocardiogram. A transesophageal echocardiogram may be more sensitive in detecting these vegetations than one performed from the outer chest surface. However, not being able to see a vegetation by an echocardiogram does not mean that endocarditis does not exist. Additional blood tests, serial assessments of changes in valve function, and further clinical suspicion may be helpful in diagnosing endocarditis.
In rare instances, some viral infections of the heart may result in myocarditis. This is an inflammatory condition of the heart that may affect the function of the heart. If suspected, blood tests may help to identify the virus. In some situations, a small sample of heart tissue called a biopsy may be helpful in diagnosing myocarditis.

Cardiovascular infection is not always easy to diagnose. Your doctor's first step will be to take your medical history and do a physical examination. From there your doctor will choose from a wide array of tests to help diagnose your condition. A chest x-ray, blood tests, an electrocardiogram, a cardiac catheterization, an echocardiogram, and a cardiac biopsy are some of the possibilities.

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