24th June 2026

You are the cardiology SHO in a district general hospital.

You are the cardiology SHO in a district general hospital. On the consultant ward rounds, your team reviews a patient who is currently being treated for a staph aureus infective endocarditis. The patient had complained of increased shortness of breath the day before, and a repeat echocardiogram has been arranged. Your consultant reviews the echocardiogram and recent blood culture results, and asks you to refer the patient to the cardiothoracic surgeons for consideration of surgery. Which of the following would be an indication for surgical referral? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.