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A 28-year-old man admitted with 3-weeks history of feeling unwell. On admission he was pyrexial and tachycardic (140/min). Cardiovascular examination revealed a loud diastolic murmur. An ECG showed sinus rhythm, and blood pressure was 140/40 mm Hg. Initial blood investigations revealed evidence of sepsis (CRP: 320).
A bedside echocardiogram performed by the author (AG) demonstrated a mobile echogenic mass (1.6×1.7 cm) attached to the aortic non-coronary cusp (figure 1A) suggestive of a vegetation (Yellow arrows). …