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Pacemaker lead vegetation sited between the right atrium and the right ventricle
  1. Zain Sharif1,
  2. Clare Fallon2
  1. 1BST Medical Scheme, RCPI, Mullingar Regional Hospital, Mullingar, Co. Westmeath, Ireland
  2. 2Department of GIM, RCPI, Mullingar Regional Hospital, Mullingar, Co. Westmeath, Ireland
  1. Correspondence to Dr Zain Sharif, Midlands Regional Hospital, Mullingar, County Westmeath, Ireland; zainsharif{at}rcsi.ie

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Case

A 64-year-old man presented with a month's history of fatigue, general malaise and occasional rigours. He was feeling feverish on examination with no peripheral stigmata of infective endocarditis. The patient had a prior history of a permanent pacemaker (PPM) placed in 1980 for symptomatic bradycardia, with …

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