The Bottom Line: In this study. the sensitivity of transesophageal echocardiography was 0.92 and the specificity was 0.95. The sensitivity of transesophageal echocardiography after a negative transthoracic echocardiography was 0.73 and the specificity was 0.98. Transesophageal echocardiography carried a 0.01% risk of death.
Heidenreich, P A, et al. “Echocardiography in patients with suspected endocarditis: a cost-effectiveness analysis.” The American journal of medicine 107.3 (1999):198-208.
The initial use of transesophageal echocardiography is the optimal strategy for most patients with suspected endocarditis. Patients with low probabilities of endocarditis (less than 2%) should not be evaluated with echocardiography, whereas those with high probabilities (greater than 60%) should be treated for endocarditis regardless of echocardiographic results.