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Radiology · Cardiac imaging: endocarditis on echocardiography
Sample itemA man with fever and a new regurgitant murmur has negative transthoracic echocardiography but a high clinical suspicion of prosthetic valve endocarditis. Which next test is preferred?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Transoesophageal echocardiography
Transoesophageal echocardiography images the valves from close range with higher resolution, and it detects small vegetations, abscesses and prosthetic valve dehiscence missed by transthoracic scanning. It is the preferred test for prosthetic valves.
Option by option
A. Ventilation-perfusion scan
A V/Q scan evaluates pulmonary perfusion.
B. Carotid Doppler
Carotid Doppler evaluates the carotid arteries.
C. Chest radiograph
A chest film cannot show vegetations.
D. Transoesophageal echocardiography (correct)
Correct. TOE is more sensitive for vegetations and root abscess.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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