Infective endocarditis (IE) is an important pathology to detect in the Emergency Department (ED), but the diagnosis is too often delayed or missed. IE ticks many boxes as a diagnosis we can “own” in Emergency Medicine (EM):

1. It is time-critical with worsening morbidity/mortality as the disease progresses
2. Patients are often critically unwell
3. Along with recent dental work and congenital heart disease, risk factors include uncontrolled diabetes and intravenous drug use, and patients in the latter two groups often have poor access to healthcare and poor compliance with follow-up instructions. Their ED visit may well be the best opportunity we have to make a life-saving diagnosis.

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