Diagnosis of an aortic valvular lesion

From the question on page 719 Clinical introduction A 59-year-old woman with hypertension presented with right-sided weakness and vision loss. Her vital signs were normal; cardiopulmonary exam was significant for a systolic and diastolic murmur. MRI of the brain showed multiple chronic bilateral infarctions, and Doppler ultrasound revealed acute left lower extremity deep vein thrombosis. Transthoracic echocardiography (TTE) to determine cardioembolic source of stroke was significant only for severe aortic valve regurgitation. To assess for cardiac vegetations, transoesophageal echocardiography (TEE) was performed (figure 1). Thrombophilic workup revealed positive antinuclear antibody (titre 1:640) and lupus anticoagulant; the remaining lupus serologies were negative. She was afebrile, without leukocytosis or positive blood cultures. During evaluation for vaginal bleeding 5 days later, she was diagnosed with stage IIIB endometrial carcinoma. Figure 1Transoesophageal echocardiogram (TEE) revealing multiple densities (*) attached to the ventricular surface of the aortic valve, seen in...
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Hypertension, Venous thromboembolism, Aortic valve disease, Clinical diagnostic tests Source Type: research