*3.2.1. Diagnosis*

Class I indications include the following: (a) TTE first line in suspected IE, (b) TEE if negative TTE or nondiagnostic but clinical suspicion of IE, (c) TEE if clinical suspicion of IE if prosthetic valve or cardiac device is present, (d) repeat TTE and/or TEE if initial examination negative but high-clinical suspicion.

Class IIa indications include the following: (a) consider echo for *Staphylococcus aureus* bacteremia and (b) consider TEE in all suspected cases of IE regardless of TTE findings, unless highquality study of native right-sided uncomplicated infection.
