PMC8424240_01
Patient's electrocardiogram showing inverted T-wave in leads II, III, and AVF.
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ECG revealed T-wave inversion in leads II, III, and AVF (Figure 1).
Patient's chest X-ray demonstrating cardiomegaly and right lower lobe consolidations with pleural effusion.
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Chest imaging revealed cardiomegaly and right pleural effusion with right lower lobe consolidations (Figure 2).
Parasternal long axis view revealing a diffused leaflet thickening of the mitral valve.
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Echocardiogram showed a dilated right ventricle with mild to moderate tricuspid regurgitation and severe rheumatic mitral stenosis with moderate to severe mitral regurgitation (Figure 3).
Transesophageal echocardiogram showing a symmetrical mass-like structure on the ventricular surface involving the tips of both leaflets extending to the body, causing a restriction in the valve function.
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Transesophageal echocardiogram showed thickened mitral valve leaflets with symmetrical mass-like structure on the ventricular surface involving the tips of both leaflets extending to the body, causing a restriction in the valve function during both cardiac phases (Figure 4).
Gross anatomy of the mitral valve leaflets in keeping with Libman-Sacks endocarditis.
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During the operation, the mitral valve was found to be grossly thickened with friable tissue and complete amalgamation of the leaflets with subvalvular apparatus (Figure 5).