What are the clinical parameters for diagnosing perivalvular extension of IE?
Clinical parameters for the diagnosis of perivalvular extension of IE include persistent bacteremia or fever, recurrent emboli, heart block, heart failure, or a new pathological murmur in a patient with IE on appropriate antibiotics. Aortic valve involvement and current IDU have been prospectively identified as independent risk factors for perivalvular abscess. On ECG, new atrio-ventricular block has a positive predictive value of 88% for abscess formation but low (45%) sensitivity. The size of vegetations is not helpful for predicting perivalvular extension.