E-page Original Image: Aortic valve aneurysm: a result or reason?

A 37-year-old patient had a cerebrovascular accident and according to history and physical examination, emboli secondary to infective endocarditis (IE) was suspected. He had no notable previous medical history. His tomography showed an ischemic area in the left cerebral hemisphere. Transthoracic echocardiography revealed a mild to moderate aortic regurgitation. On parasternal long-and short-axis views, a small mass was found attached to the left coronary cusp of the aortic valve. It resembled a cystic mass rather than a vegetation (Fig. 1). On transesophageal echocardiogram, the cystic mass was actually found to be the aneurysmatic left coronary cusp (Fig. 2, Video 1, 2. See corresponding video/movie images at www.anakarder.com). No solid lesion was discovered. The cusp prolapsed into the left ventricular outflow tract (LVOT) during diastole.