1 IE into RA
The colour flow
2 AV short twin
- The diagnosis should be quite apparent
- Here are more views
3 AP4
4 AV zoom
5 AV SAX
- This view shows the vegetation extending from the aortic valve into the tricuspid valave
- It also shows the fistula connecting the aortic root to the RVOT
- Thus the earlier colour flow mapping shows a shunt from the aortic root into the RVOT
- The following shows this in different angle
6 AV long twin

From the 30 degree view

Conclusion
- This patient has an aortic infective endocarditis with large vegetation attached to the NCC
- However, all the cusp have been compromised with resultant severe AR
- The vegetation has also caused a fistula into the RVOT as well as the Tricuspid inflow
- Patient was treated with anti-biotic with a view to surgical intervention