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A woman in her 50s was admitted to our cardiovascular department for worsening dyspnoea. Her medical history was noteworthy of early-onset memory impairment and mild renal dysfunction. Physical examination revealed a diastolic decrescendo murmur and livedo racemosa. Echocardiography showed a large mass on the aortic valve with severe aortic regurgitation, left ventricular dilatation and systolic dysfunction. Thyroid function was normal. Blood cultures, antiphospholipid and antinuclear antibodies (ANA) were negative. During her hospitalisation she experienced several transient ischaemic attacks. Cerebral CT scan and MRI showed widespread parenchymal microinfarcts. Immunosuppressive therapy was …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.
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