• Cardiothoracic pathology
• endocarditis
• clinical audit
• cardiothoracic pathology
• endocarditis
• infections
• ENT
• oral pathology
• lung
• carcinoma
• pulmonary pathology

Despite the relatively low incidence of infective endocarditis (IE), it is associated with significant morbidity and has a mortality of 20–26% during the initial hospital admission.1 Clinical diagnosis of IE is made using Duke's criteria,2 and histopathological examination (HPE) of resected valvular tissue (or embolic fragments) remains the gold standard for the diagnosis of IE.3 However, it was felt that in our histopathology department, HPE is often requested to exclude IE in cases where there is no clinical suspicion of endocarditis, and in the literature, there is to be no definitive best-practice/evidence-based approach to when HPE of cardiac valves should be done.

In 2009, we performed an audit examining the pattern of referral of cardiac valves to the department, and this included the following …