Echocardiographic demonstration of tricuspid valvulitis and right atrial thrombus complicating an infected artificial pacemaker:a case report.

A right ventricular artificial demand pacemaker was implanted into a 59-year-old man with supra-Hisian complete heart block. His postoperative course was complicated by Staphylococcal aureus septicemia, which was controlled with antibiotics. A year later, S. aureus was again isolated from the blood. Echocardiography showed thickening of the tricuspid valve leaflet and multiple echoes in the right atrium. Autopsy findings included tricuspid leaflet thickening and an overlying right atrial thrombus. The echocardiogram is thus useful in localizing an infected valve in bacterial endocarditis and in demonstrating the presence of the thrombus.