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An 89-year-old male was referred to the echo laboratory for further investigations of a 6-day history of high fever and wet cough. His past medical history was largely unremarkable and so was his cardiac physical examination. Electrocardiogram showed sinus rhythms with an incomplete right bundle branch bloc. He had a poor echogenic window in transthoracic echocardiography which revealed no significant valvular heart disease and no evidence of mobile echodense masses implanted in a valve or mural endocardium however it was suspicious for tow echodense masses tributary to the lateral left atrial wall and the interatrial septum.
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