A 45-year-old man presented with complaints of intermittent fever and chest pain for 3 weeks. He had a 30-year history of patent ductus arteriosus (PDA). Transthoracic- echocardiography (TTE) and transesophageal echocardiography (TEE) successfully diagnosed aortic vegetations and cast-type PDAs, but additional PDA terminal vegetations were found TEE, and PDA vegetations were also found in coronary CT. Multi model imaging has important value for its accurate diagnosis and treatment.