**1. Introduction**

Echocardiography is fundamental to the diagnosis, risk stratification, management, and follow-up of patients with IE [1]. Modern era transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) enable cardiac anatomy, pathology, and physiology to be assessed in real time. Echocardiography is a readily available, portable imaging modality

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

that uses the properties of reflected ultrasound waves to construct high-quality two-dimensional (2D) and three-dimensional (3D) images of the heart without radiation exposure. Echocardiography should be utilized at the first opportunity when IE is suspected, to provide an early diagnosis and facilitate important management decisions. However, echocardiographic findings should always be interpreted in their clinical context to maximize diagnostic utility.

This chapter will outline the role echocardiography in the management of IE. In addition, the history of cardiac ultrasound, its diagnostic accuracy, limitations, and emerging technologies such as 3D imaging will be reviewed. Finally, there is a section on imaging protocols and quality control to provide guidance to echocardiography laboratories wishing to pursue excellence in the field.
