A normal TEE does not rule out endocarditis

Sensitivity:

• TTE = 60%
• TEE = 90%

Difficult situations:

1. Very small (< 2 mm) vegetation
2. Non vegetant endocarditis
3. Prosthetic and pacemaker endocarditis
4. Mitral valve prolapse with thickened valves
5. Vegetation not yet present or already embolized