Pneumococcal Endocarditis Presenting as Sinus Arrest.

https://e-jcvi.org A 76-year-old man with recurrent syncope and a history of bioprosthetic aortic valve (AV) replacement 8 years prior was transferred to the emergency department. On presentation, electrocardiogram showed sinus arrest with a seizure-like movement; thus, a temporary pacemaker was implanted (Figure 1). Radiography showed pulmonary infiltrates, and blood culture results showed Streptococcus pneumonia infection (Figure 2). Serial transthoracic echocardiography showed only valvular leaflet thickening. Transesophageal echocardiography was then attempted several times, but failed.