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Aorto-right atrial and right ventricular fistulae: a very rare complication of native bicuspid aortic valve endocarditis
  1. Ashan Gunarathne1,
  2. Janette Hunt2,
  3. Anthony Gershlick3
  1. 1Department of Cardiology, Glenfield Hospital, Leicester, UK
  2. 2Department of Cardiology, Derby General Hospital, Derby, UK
  3. 3Department of Cardiology, Glenfield Hospital, Leicester, UK
  1. Correspondence to Dr Ashan Gunarathne, Department of Cardiology, Glenfield Hospital, Leicester LE39QP, UK; ashan{at}

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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). …

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  • Contributors AG managed the case and prepared the manuscript echocardiography expertise was provided by JH. AGe reviewed the manuscript and was involved in preparing it as well as being the consultant in charge of patient care.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This is based on a clinical case so ethics approval is not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.