Discussion:
TEE is the gold standard for non-invasive evaluation of intracardiac masses; however, in our patient, the location of the vegetation was unusual as it was attached to the endocardial border on the high-pressure (ventricular) side. It is also highly unlikely for the vegetation of that size to initially present only with embolic phenomenon without any constitutional or infective symptoms. Cases in which the suspicion of vegetation versus cardiac tumor exists, an MRI could help make that distinction (1, 2).