Aortic valve endocarditis complicated by complete heart block

A 34-year-old man with severe aortic incompetence caused by Streptococcus viridans developed severe central chest pain followed by complete heart block, multifocal ventricular extrasystoles, lengthening of the QTc and signs of cerebral emboli and pulmonary oedema. Early antibiotic therapy along with pacing, non-invasive investigations coupled with early surgery contributed significantly to the patient's survival.