**12. Summary**

Echocardiography is fundamental in the management of all aspects of endocarditis from diagnosis, identifying complications and prognostic factors through to guiding surgery, and providing follow-up after treatment. Over the past 40 years, since the introduction of M-mode, echocardiography has evolved rapidly, with high-quality 2D and 3D imaging now in routine clinical use. Echocardiography is readily available, cost-effective, and safe, without exposure to ionizing radiation.

Confirming the diagnosis of endocarditis has never been easier with modern era echo; however, mortality remains high, in part due to delayed diagnosis. Maintaining a high-clinical suspicion for IE in at-risk patients must be combined with early referral for echo to ensure prompt diagnosis and institution of appropriate therapy. Formation of an expert multidisciplinary IE team and appropriate use of echocardiography has the potential to save lives and improve patient outcomes.
