Tricuspid Valve Infective Endocarditis Seen on Point-of-Care Ultrasound: A Case Report

Intravenous drug use is a major risk factor for infective endocarditis (IE), particularly right-sided disease involving the tricuspid valve. Early diagnosis remains challenging as patients often present with nonspecific symptoms, while delays in recognition can result in severe complications including septic emboli, valvular dysfunction, and sepsis. Point-of-care ultrasound (POCUS) has emerged as a valuable bedside modality capable of rapidly identifying valvular abnormalities and expediting the diagnosis of IE in the emergency department. We present a case of tricuspid valve infective endocarditis in a patient with a history of intravenous drug use in whom cardiac POCUS identified a large tricuspid vegetation prior to comprehensive echocardiography. Subsequent evaluation demonstrated methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with multiple septic embolic complications. The patient ultimately underwent percutaneous vegetation debulking in addition to intravenous antibiotic therapy. This case highlights the utility of bedside cardiac POCUS in facilitating rapid recognition, expedited specialty consultation, and timely management of infective endocarditis in high-risk patients presenting to the emergency department.