What are the recommended actions for a patient with an initially positive TTE and a high risk for intracardiac complications?
TEE should be obtained as soon as possible. Repeating the TEE in 3 to 5 days (or sooner if clinical findings change) after an initial negative result is recommended when clinical suspicion of IE persists. Additionally, if a patient with an initially positive TTE develops worrisome clinical features during antibiotic therapy, such as unexplained progression of heart failure symptoms, change in cardiac murmurs, and new atrioventricular block or arrhythmia, emergent evaluation by TEE should be done.