case_images: PMC3891165_01
case_images: Two dimensional transthoracic echocardiogram showing unusual posterior valve appearance. The prolapsing posterior mitral valve leaflet is fixed in the left atrium during systolic and diastolic cycles (arrow). There was no sign of infectious endocarditis.
case_images: kjim-20-264-g001.jpg
case_images: PMC3891165_01_kjim-20-264-g001.jpg
case_images: F1
case_images: The valve prolapse appearance was notable because the prolapsing posterior mitral valve was focally fixed in the left atrium during systolic and diastolic cycles (Figure 1).
case_images: Mitral valve histological analysis demonstrating extensive fibrinoid necrosis with active inflammation (mainly neutrophilic infiltration), which is unusual for ordinary valvulopathy.
case_images: kjim-20-264-g002.jpg
case_images: PMC3891165_01_kjim-20-264-g002.jpg
case_images: F2
case_images: Histological examination of heart tissue showed fibromyxoid degeneration with chronic active inflammation in the aortic wall, and chronic active inflammation with fibrinoid necrosis of the aortic and mitral valves (Figure 2).