Clickbait: A Rare Case of Monomorphic Ventricular Tachycardia and Clicking Sensation without Infectious Presentation Revealed as Infective Endocarditis with Aortic Root Abscess

Presenting symptoms of infective endocarditis (IE) typically includes infectious signs such as diaphoresis, fever, and malaise. Pathogenic microorganisms implicated in IE may form vegetations, collection of debris that may subsequently embolize. Notable complications and concomitant sequelae of systemic embolization from resulting from valvular vegetations include stroke, acute renal failure, and cutaneous manifestations. Valvular dysfunction warranting surgical repair does not preclude redo-repairs from subsequent emboli, highlighting the extensive propensity of IE to cause acute decompensation across multiple domains. A presenting feature of arrhythmia stemming from valvular dysfunction have been appreciated in the literature. However, literary accounts of ventricular tachycardia (VT) as the resultant arrhythmia are scant. Moreover, these accounts usually include concomitant infectious presentation. We report the case of a 36-year-old male with a past medical history of Bartonella spp. endocarditis and aortic valve repair who appeared to the emergency department with acute onset monomorphic VT. Complicating his presentation was a reported sensation of clicking in his surgically repaired valve while lacking infectious symptoms. Arrhythmia was treated with further workup delineating S. epidermidis vegetations and aortic root abscess successfully treated with antibiotics and ICD placement.