Echocardiographic diagnosis of isolated pulmonary valve endocarditis

Sir, In the case report (Brtish Heart Journal 1982, 47: 298-300), the authors confirm the value of echocardiography in the diagnosis ofpulmonary valve vegetations. They do not comment on the echocardiographic assessment of the pattern of leaflet motion. We have demonstrated the value of the cross-sectional echocardiogram in showing the flail nature of the leaflets in a further patient with pulmonary valve vegetations,' and it would be interesting to know if the authors have any information in their case. The two dimensional approach is more likely to show details of the size and shape of the vegetations and the leaflet motion than M-mode echocardiograms. Our patient has now been reviewed over a two year period, and there have been no changes in the echocardiographic features, and no deterioration in his clinical condition. Surgery does not seem to be required in such cases if the initial infection can be successfully treated with antibiotics.