The heart of the matter

Authors: Maria Celina Bondoc, Ivana Lutchman / Editor: Steve Corry-Bass / Reviewer: Tom White / Codes: / Published: 06/09/2019

A 62-year-old woman presents to the emergency department (ED) with a 3-day history of shortness of breath and chest pain, fever, night sweats, weight loss and arthralgia.

The only thing of note in her past medical history is a recent hospital admission for presumed UTI and Staphylococcus aureus bacteraemia.

Observations: BP=120/70 HR=70 RR=18 SpO2=94% on room air, temp=37.8 degrees Celsius.

Examination findings include a soft systolic murmur in the left parasternal area, Roths spots, Janeway lesions and Osler nodes.

Investigations for ACS turned out to be negative. You suspect infective endocarditis (IE).

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