What are the echocardiographic features that may suggest a potential need for surgical intervention?
The echocardiographic features that may suggest a potential need for surgical intervention include persistent vegetation after systemic embolization, anterior mitral leaflet vegetation, particularly with size >10 mm, embolic event during first 2 weeks of antimicrobial therapy, embolic events during or after antimicrobial therapy, increase in vegetation size after 4 weeks of antimicrobial therapy, acute aortic or mitral insufficiency with signs of ventricular failure, heart failure unresponsive to medical therapy, valve perforation or rupture, perivalvular extension, valvular dehiscence, rupture or fistula, and large abscess or extension of abscess despite appropriate antimicrobial therapy.