A case of mitral valve accessory tissue incidentally diagnosed with echocardiography in old age

Abstract

The case was an 83-year-old man who was taking steroids due to adrenal insufficiency. Facial edema and leg edema worsened, and he was admitted for detailed examination. Transthoracic cardiac ultrasound examination revealed a membranous structure of about 20 mm attached to the anterior leaflet of the mitral valve, and showed edematous movement protruding into the left ventricular outflow tract during contraction. Further detailed observation with transesophageal cardiac ultrasound revealed that the membranous structure was accessory mitral valve tissue attached to the anterior leaflet of the mitral valve by a string-like structure. Although no other cardiac malformations were observed, a pressure gradient in the left ventricular outflow tract was observed.