English: :The patient is a 32 year old male who has a history of IV drug use, presents as a transfer from an outside hospital (OSH) for sepsis. Was taken to the OSH with bouts of lethargy/AMS mixed with episodes of combativeness. Noted to be febrile, hypotensive. Given 5L NS and a dose of vancomycin PTA. On exam you hear a blowing diastolic murmur. What is the diagnosis and most appropriate management for this patient?