Background: Echocardiography is an essential evaluation in the diagnosis of infectious endocarditis (IE). Transthoracic echocardiography (TTE) is a portable study that is widely available and non-invasive. Though transesophageal echocardiography (TEE) is traditionally known for higher sensitivity and specificity, it is speculated that improvements in modern TTE imaging could produce higher diagnostic yield than previously thought. [...]

Case Presentation: A 49-year-old male presented with progressive lower extremity edema, exertional dyspnea and orthopnea for three weeks. Past medical history significant for non-ischemic cardiomyopathy, systolic heart failure and moderate aortic regurgitation (AR) diagnosed one year ago. Physical exam was significant for jugular vein distention, bibasilar crackles, loud 3/6 diastolic murmur in the aortic area [...]