Clinical and echocardiographic characteristics of isolated right-sided infective endocarditis

LI Meng-meng; SUN Jia; JI Shu-jiao

doi:10.13820/j.cnki.gdyx.20250720

Abstract：Objective To investigate the clinical and echocardiographic characteristics of isolated right-sided infective endocarditis(RSIE),aiming to improve the recognition and echocardiographic diagnostic accuracy of RSIE.Methods A retrospective analysis was conducted on 45 patients diagnosed with isolated RSIE at Henan Provincial Chest Hospital between January 2013 and December 2024.The cohort included 20 males(44.4％)and 25 females(55.6％),with a mean age of(39.93±19.92)years.Clinical manifestations,underlying cardiac conditions,blood culture results,and echocardiographic findings were collected and analyzed.Results Fever was the most common clinical symptom(44/45,97.8％),followed by pulmonary-related symptoms(33/45,73.3％).The most frequent physical signs were sple-nomegaly(33/45,73.3％)and cardiac murmurs(28/45,62.2％).Congenital heart disease was the most prevalent un-derlying cardiac condition(24/45,53.3％).Blood cultures were positive in 24 patients(53.3％),predominantly for Streptococcus and Staphylococcus species.The tricuspid valve was the most frequently involved site for vegetations(31/45,68.9％).Transthoracic echocardiography(TTE)detected vegetations in 40 patients(88.9％),with 2 cases missed(4.4％)and 3 cases misdiagnosed(6.7％).The missed cases were later confirmed by transesophageal echocardiography(TEE).Conclusion RSIE often presents with non-specific clinical symptoms.In patients with predisposing risk fac-tors for RSIE who develop fever and pulmonary symptoms,TTE should be promptly performed.When necessary,TEE or 3D-TEE can provide further diagnostic value.Echocardiography plays a crucial role in the early diagnosis and treatment of RSIE.