case_images: PMC9979955_01
case_images: This is a still image of a parasternal long view of the heart. Overall, there are some irregularities in the basal aspect of the inter-ventricular septum and thickness to one of the leaflets of the tricuspid valve.
case_images: pocusj-06-14755-g001.jpg
case_images: PMC9979955_01_pocusj-06-14755-g001.jpg
case_images: pocusj-06-14755-g001
case_images: This is a still image of a parasternal long view of the heart. Overall, there is a jet indicating regurgitant flow across the basal aspect of the inter-ventricular septum. There seems to be doppler flow in the left atrium. On an additional view of the mitral valve, there was no evidence of mitral regurgitation. This jet extended within the left atrium may be a reflection of added gain from the jet of the VSD. With the clinical exam of a holosystolic murmur at the left lower sternal boarder, and this image, a ventricular septal defect (VSD) was suspected.
case_images: pocusj-06-14755-g002.jpg
case_images: PMC9979955_01_pocusj-06-14755-g002.jpg
case_images: pocusj-06-14755-g002
case_images: This is a still image of an apical four chamber view of the heart. Overall, there is a thickness noted in one of the leaflets of the tricuspid valve. With his history of fever, suspicion of tricuspid valve endocarditis leading to symptoms of right heart failure was suspected.
case_images: pocusj-06-14755-g003.jpg
case_images: PMC9979955_01_pocusj-06-14755-g003.jpg
case_images: pocusj-06-14755-g003