Endocarditis

M.M. is a 51-year-old female presenting with a couple months of persistent, nonspecific fatigue and low energy, stating she is “tired all the time” and “doesn’t feel like doing anything,” which is a change from her baseline. She has not sought medical care in several years and came in for a check-up due to the ongoing symptoms. She cannot identify a trigger or clear pattern to the fatigue despite repeated attempts to clarify timing or progression. She denies shortness of breath, activity intolerance, weight gain, chest discomfort, fever, headache, urinary changes, rash, recent travel, recent illness or surgery, and denies muscle/joint pain. She also denies depressive symptoms, anhedonia, low motivation, hopelessness, worthlessness, or sleep problems.