Infective endocarditis in a parachute-like asymmetrical mitral valve

A 21-year-old woman was admitted to our unit with suspected infective endocarditis. Transthoracic and transoesophageal echocardiogram demonstrated vegetation in a parachute-like asymmetrical mitral valve with severe mitral regurgitation. She was completely asymptomatic before this presentation. Though there was no evidence of mitral stenosis, this deformity is associated with transvalvular turbulence, which would account for the increased likelihood of infective endocarditis. She underwent a prosthetic mitral valve replacement with a 21 mm ATS mechanical valve.