Figure 1.
A. Apical two-chamber transthoracic echocardiography view showing no obvious vegetation.
B. Bicommissural transesophageal echocardiography view showing a mobile vegetation (arrows) on the surface of left ventricular muscle just below the anterolateral commissure of the mitral valve.
C. Resection of the vegetation approached from aortic valve was performed on the seventh day of hospitalization. Surgical findings show a vegetation (arrows) on the surface of left ventricular muscle and subvalvular tissue just below the anterolateral commissure of the mitral valve.
D. A histological examination of the vegetation shows extensive inflammatory cell infiltration with fibrin precipitation and necrotic tissue (hematoxylin and eosin, original magnification x 100).
E. 18-Fluorodeoxyglucose positron emission tomography shows no evidence of abnormal accumulation in left ventricular muscle.
F. gallium-67 scintigraphy shows no evidence of abnormal accumulation in left ventricular muscle.
LA = Left atrium; LV = left ventricle.