Right-sided infective endocarditis or thrombus? Report of two cases diagnosed by transthoracic echocardiography

Background: Right-sided infective endocarditis (RSIE) is a relatively uncommon condition which is difficult to distinguish from thrombus, particularly when the site of infection or the patient's symptoms are atypical. There have been few reports exploring the differential diagnostic and analytical features between RSIE and thrombus.

Case presentation: Here, we presented two cases of RSIE-one involving the tricuspid valve and the other affecting the pulmonary artery. Notably, the second case was initially misdiagnosed as thrombus based on the findings of by computed tomography angiography(CTA).

Conclusions: Vegetation and thrombus can be distinguished according to the nature of the mass, its attachment location, and the clinical manifestation. Echocardiography can observe both the location and size of the mass, and the dynamic changes in cardiac hemodynamics and cardiac morphology, thereby facilitating an effective distinction between vegetation and thrombus.