is true that the patient's clinical picture and positive
blood cultures are consistent with bacterial endocarditis,
and that the right atrial mass could easily represent
a large vegetation. However, the homogenous and "soft"
echogenic appearance, filamentous projects and varying
contour are more in keeping with a large right atrial
thrombus in this patient with chronic atrial fibrillation.
An underlying vegetation probably served as a nidus
for the thrombus but is not felt to account for the
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