An intravenous drug user presents with a fever of unknown origin, flu-like symptoms, dyspnea, and chest pain. Which ultrasound finding is mostly likely associated with this presentation?
Intravenous drug use is a major risk factor for infective endocarditis, particularly involving the tricuspid valve and sometimes left-sided valves. Symptoms like fever, flu-like illness, dyspnea, and chest pain suggest possible septic emboli or valve destruction.
Echocardiographic findings associated with endocarditis include mobile echogenic masses attached to valve leaflets (vegetations), valve thickening, or destruction. These findings are diagnostic and guide treatment.
Aortic dissection, hypertrophic cardiomyopathy, and mitral valve prolapse can present with different clinical features and echocardiographic findings not consistent with infectious vegetations.
These clinical and echocardiographic correlations are detailed in the ASE guidelines on infective endocarditis and the "Textbook of Clinical Echocardiography"【16:Textbook of Clinical Echocardiography, 6e†p.470-475】【12:ASE Infective Endocarditis Guidelines†p.380-390】.
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