Case:
A 33-year-old woman with history of untreated patent ductus arteriosus (PDA) presented with a chief complaint of fever. A grade 3 pan-systolic murmur best heard in the 2nd intercostal space along the left sternal border, radiating to the left clavicle (File1-4), suggestive of infective endocarditis (IE). Streptococcus oralis was detected in blood cultures. Transesophageal echocardiography showed a vegetation adjacent to the PDA, confirming the diagnosis of IE. The file provides a rare audio-recording of PDA-associated IE.1)2) Even in adults without a previous diagnosis of PDA, it is important to consider PDA-associated IE when hearing a murmur as in this case.