Echocardiographic manifestations of valvular vegetations

Eight patients with autopsy or surgically proved valvular vegetations were examined using echocardiography. Five of these patients had lesions on the aortic valve and three had lesions on the mitral valve. The echocardiographic finding in these patients was a non-uniform thickening of valve leaflets which exhibited unrestricted motion. Often the abnormal echoes which produced the thickened valve had a shaggy appearance. In all eight patients the location of the echocardiographic abnormality correlated with the anatomic findings at surgery or autopsy. In one patient the diagnosis of bacterial endocarditis was first suspected following the echocardiographic examination and only subsequently was a heart murmur heard. These findings indicate that echocardiography may play a useful role in elucidating the pathological anatomy of the bacterial endocarditis with vegetation; however, the length of time from the onset of clinical illness to echocardiographic diagnosis remains unknown.