*3.1.2. Transesophageal imaging*

Appropriateness guidelines for the use of TEE are more generic and are not necessarily specific for endocarditis. The use of TEE is considered reasonable in the following situations: (a) it is anticipated TTE imaging would be suboptimal, (b) to assess for interval change, if it is likely to guide a change in therapy, (c) assess valvular structure for planned interventions, and (d) to diagnose endocarditis if moderate pretest probability in certain subgroups, such as staphylococcal bacteremia or fungemia, prosthetic valves or intracardiac devices [28].

Inappropriate indications include the following: (a) if TTE is likely to be diagnostic, (b) followup TEE, when anticipated it would not change therapy, and (c) to diagnose IE with a low pretest probability [28].
