Halit Acet, Recep Tekin, Faruk Ertas and Zihni Bilik
A 30 year-old female who had undergone a DDD mode Pacemaker (PM) implantation 1 year ago at the another institute due to total atrioventricular block. One month before her present admission, she started to experience chills and shivering as the main complaints. For the last 2 weeks she also had fever and dyspnea (NYHA 2). She had a De Vega annuloplasty for ebstein anomaly during primary atrial septal defect repair 20 years ago at history. Her arterial blood pressure was 110/60 mmHg and pulse of 85 beats/minute with a regular rhythm, her body temperature was 36.5°C. On physical examination 3-4 /6 systolic murmur was heared over the tricuspid valve area. Other system examinations were normal.
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