Discussion:
TEE is the gold standard for non-invasive evaluation of intracardiac
masses; however, in our patient, the location of the vegetation was
unusual as it was attached to the endocardial border on the
high-pressure (ventricular) side. It is also highly unlikely for the
vegetation of that size to initially present only with embolic
phenomenon without any constitutional or infective symptoms. Cases in
which the suspicion of vegetation versus cardiac tumor exists, an MRI
could help make that distinction (1, 2).