Reply To: Another interesting case
This sounds like a fun medicine case 🙂
Is the murmur new or had it previously been noted?
Looking at the images, I think that the left atrium looks subjectively enlarged, with a thickened mitral valve leaflet and some prolapse of the valve. Could this be a vegetative bacterial endocarditis lesion?
For further investigations I would want a blood culture, urine culture and I would want to examine the lame leg to look for a wound/source that could cause a blood borne infection (if anything was found then I would sample/culture if possible). After this I would be looking at imaging abdo ultrasound and CT looking for any other lesions (primary or secondary).