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. 2019 May 14;12(5):e225947. doi: 10.1136/bcr-2018-225947

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© BMJ Publishing Group Limited 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Transoesophageal echocardiographic images showing a large 19×16 mm vegetation attached to two and possibly all three aortic valve leaflets and a smaller 11×9 mm vegetation attached to the ventricular surface of the anterior mitral leaflet.