Other Investigations

Cardiac catheterisation is useful for pre surgical evaluation but is not recommended routinely.

Electrocardiogram and chest X-ray will be required to refine the diagnosis, exclude other causes for the clinical presentation and evaluate potential complications (eg cardiac failure and ischaemia).

Ultrasound and CT/MRI scans may be required to detect peripheral manifestation due to embolisation. This may include imaging the CNS to look for cerebral abscess or ischaemic stroke. Continued fever and positive blood cultures despite adequate treatment should prompt visualisation of abdominal viscera for detection of abscess, especially in the spleen.