PMC5234559_01
(A) Apical four-chamber view. (B) Long axis view.. Notes: (A) The red arrow shows the mass in the mitral valve during diastole. (B) The blue arrow shows a mass in the anterior leaflet of the mitral valve.
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During evaluation, transthoracic echocardiography revealed a 2.1x2 cm hyperechoic lesion on the anterior leaflet of the mitral valve (Figure 1A: a red arrow shows a mass in the apical four-chamber view. Figure 1B: a blue arrow shows the mass in the long axis view), which was associated with severe mitral regurgitation (regurgitant volume of 73 mL and vena contracta of 19 mm) and an eccentrically directed posterior jet (despite jet angle, the effective regurgitation orifice was >0.4 cm2).
(A) CT angiography of lower extremities show intraluminal filling defects with occlusion of the left common iliac artery (red arrow) and left common femoral artery (blue arrow). (B) Intraluminal filling defect with occlusion in the distal popliteal artery of both limbs (red and blue arrows).. Abbreviation: CT, computed tomography.
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A subsequent computed tomography (CT) angiography of the lower extremities showed intraluminal filling defects in left common femoral and iliac artery (Figure 2A) and in the distal popliteal artery of both limbs (Figure 2B).