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A patient with a history of HIV and known coronary artery disease presented with fevers. Chest x-ray showed bilateral infiltrates, and a trans-thoracic echocardiogram (TTE) obtained on the first hospital day showed an ejection fraction of 43% with hypokinesis of the basal and mid-anterior segments. The patient's course was complicated by continued fevers but blood cultures remained negative; upon rereview of the initial TTE, a highly mobile echogenic linear mass was appreciated on the left ventricular outflow tract side of the aortic valve (see online supplementary video …
Contributors JK drafted the manuscript and made revisions as suggested by Professor Otto. He is the guarantor. MM revised the draft manuscript.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.