A patient with a history of coarctation of the aorta presents with prolonged fever and a new heart murmur. What is the likely diagnosis?

In this scenario, the presence of a patient with a history of coarctation of the aorta, along with prolonged fever and a new heart murmur, strongly suggests bacterial endocarditis as the likely diagnosis.

Bacterial endocarditis is an infection of the heart valves or the inner lining of the heart, which is often associated with pre-existing cardiac structural abnormalities, such as coarctation of the aorta. Coarctation can lead to turbulent blood flow, creating areas of increased risk for the formation of vegetations on heart valves, facilitating the development of endocarditis. The prolonged fever indicates an ongoing infection process, while the new heart murmur points to potential valvular involvement, both classic findings in endocarditis.

The other potential diagnoses do not align as closely with the presented symptoms and patient history. Acute myocardial infarction typically presents with chest pain, shortness of breath, or other symptoms indicative of ischemia rather than prolonged fever or a new murmur. Acute pericarditis is characterized by chest pain that may improve with leaning forward, and fever can be present, but it does not commonly cause a new heart murmur in the same context as bacterial endocarditis. Restrictive cardiomyopathy