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A 79-year-old man presented to our Emergency Department with septic shock and congestive heart failure secondary to infective endocarditis of his right ventricular pacing system. He had undergone recent resynchronisation biventricular pacing for dilated cardiomyopathy and moderate rheumatic mitral stenosis. Transoesophageal echocardiography revealed multiple large fibrin-plated thrombi attached to …
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