A 71-year-old man who had rheumatic fever as a child is admitted to the cardiology ward with suspected infective endocarditis.. Lengthening of the PR interval on ECGia

A 71-year-old man who had rheumatic fever as a child is admitted to the cardiology ward with suspected infective endocarditis. This is confirmed by blood cultures and echocardiography.
Which one of the following is most likely to be represent a need for surgical intervention?
A.A A septic embolism in the right kidneyia
B.A Persistent pyrexia after 48 hours of antibioticsia
C.A Lengthening of the PR interval on ECGia***
D.A Pre-existing left ventricular impairmentia
E.A Streptococcus viridans isolated on blood cultures.
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