case_images: PMC6795233_01
case_images: Coronary angiogram images before (
  A) and after (
  B) the first primary angioplasty of the right coronary artery.
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case_images: PMC6795233_01_f1000research-8-20896-g0000.jpg
case_images: f1
case_images: He underwent a successful primary angioplasty of the right coronary artery (RCA) with a bare metal stent ( Figure 1).
case_images: Coronary angiogram images of the second primary angioplasty:
  A and
  B show the intrastent thrombus with mycotic aneurysm of the right coronary artery.
  C and
  D show the right coronary artery angioplasty with an overlapping bare metal stent.
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case_images: PMC6795233_01_f1000research-8-20896-g0001.jpg
case_images: f2
case_images: An urgent coronary angiogram showed a thrombus with an aneurysm on the distal part of the RCA stent and a Thrombolysis In Myocardial Infarction (TIMI) 3 flow (normal flow) ( Figure 2A and 2B). An additional angioplasty using a second bare metal stent overlapping with the previous one was successfully performed with exclusion of the aneurysm and disappearance of the thrombus. ( Figure 2B and 2C).
case_images: Imaging showing tricuspid valve vegetation (arrow) with hematoma around the right coronary artery (arrowhead) and pericardial effusion in transthoracic echocardiography (
  A and
  B) and cardiac computed tomography scan (
  C).
  D: computed tomography coronary angiography showing the right coronary artery aneurysm excluded by the overlapping stent.
case_images: f1000research-8-20896-g0002.jpg
case_images: PMC6795233_01_f1000research-8-20896-g0002.jpg
case_images: f3
case_images: Echocardiography showed vegetation (17 x 14 mm) at the level of the tricuspid valve with a moderate tricuspid regurgitation and a moderate pericardial effusion ( Figure 3A and 3B). Cardiac CT scan confirmed the vegetation in the right ventricle with hematoma around the RCA and pericardial effusion ( Figure 3C). Figure 3D). Following a thorough search for the underlying cause, we concluded that the temporary cardiac pacing was the most likely origin of the tricuspid valve infective endocarditis.