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Endocarditis Heart Failure — SCE Infectious Diseases MCQ

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HardBone & Joint InfectionEndocarditis Heart FailureSCE Infectious Diseases

During treatment of aortic-valve endocarditis, a patient develops new PR prolongation and persistent fever. Which investigation-and-escalation strategy best addresses the new finding?

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Correct answer: C — Repeat urgent TOE and cardiac CT for peri-annular extension

The best answer is “Repeat urgent TOE and cardiac CT for peri-annular extension”. New conduction delay in aortic endocarditis suggests peri-annular extension or abscess near the conduction system. Urgent high-resolution valve imaging and endocarditis-team review are required because uncontrolled local infection can create a surgical indication; pacing alone does not treat the source.

Reference: 2023 ESC Guidelines for infective endocarditis: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Endocarditis-Guidelines