Abstract
Infective endocarditis is a challenging diagnosis that is rarely made in the emergency department. As the use of
focused emergency ultrasound expands into more applications, including advanced echocardiography, the
diagnosis of infective endocarditis may be made earlier, potentially leading to more timely treatment. We report a
case of an ill-appearing patient presenting to the emergency department with an indwelling central venous
catheter, a cardiac murmur, and necrotic toes, who was diagnosed with a large tricuspid vegetation and prominent
tricuspid regurgitation on bedside emergency ultrasound. A cardiologist-performed echocardiogram confirmed
these findings during the patient's hospital admission.