PMC7640571_01
Trans-esophageal echography showing vegetation on the auricular slope of the large mitral valve measuring 11/14 mm.
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Trans-thoracic ultrasound with trans-esophageal echocardiography supplement found a paradoxical low flow/low gradient severe aortic stenosis (1 cm2 area, the mean gradient at 29 mmHg and maximum velocity at 3 m/s), associated with moderate mitral stenosis (surface at 2.2 cm2, the average gradient at 3mmhg), with 11/14 mm mobile vegetation at the expense on the middle segment of the anterior leaflet (Fig. 1).
An axial CT image showing a lesion of the pancreatic head with double-duct sign.
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Of note, abdominal CT showed a common bile duct dilatation with a 178 mm lesion on the head of the pancreas "most likely cystic in nature" (Fig. 2).