Role of the New Physical Examination Minor Criterion (New Heart Murmur) for the Diagnosis of Infective Endocarditis

Open Forum Infect Dis. 2024 Dec 19;12(1):ofae736. doi: 10.1093/ofid/ofae736. eCollection 2025 Jan.

Abstract

Among 3127 episodes of suspected infective endocarditis, the 2023 Duke-International Society for Cardiovascular Infectious Diseases clinical criteria showed an accuracy of 90% for infective endocarditis diagnosis. A new heart murmur was present in 690 (22%) episodes. Excluding imaging and surgical findings decreased the accuracy to 73%, while using the physical examination criterion slightly improved the accuracy to 78%.

Keywords: Duke criteria; International Society for Cardiovascular Infectious Diseases (ISCVID); heart murmur; infective endocarditis; physical examination.