This patient is an 83-year-old man with active lung cancer, and he was on chemotherapy. He had never had surgery and had never received radiation therapy.

He was referred to the emergency room for evaluation of shortness of breath. A transthoracic echocardiogram showed a possible vegetation of the aortic valve. A transesophageal echocardiogram (TEE) was performed to further evaluate the aortic valve.

See Figures 75-1, 75-2, 75-3 and 75-4 and Videos 75-1 to 75-4.