Pitfall in Echocardiography: infective endocarditis or valvular strand? Case report

Area of Science:

• Cardiology
• Medical Imaging
• Pathology

Background:

• Lambl's excrescences are congenital or acquired anomalies of the heart valves.
• They are often incidental findings and typically asymptomatic.
• Distinguishing Lambl's excrescences from other cardiac masses can be challenging.

Observation:

• This case report details a classic presentation of Lambl's excrescences.
• Transesophageal echocardiography (TEE) provided detailed visualization of the excrescences.
• The excrescences were characterized as thin, filiform, mobile processes attached at valvular closure lines.

Findings:

• TEE confirmed the presence of mobile, filiform structures consistent with Lambl's excrescences.
• The attachment points at the valvular closure lines were clearly delineated.
• The morphology observed was typical for this specific cardiac lesion.

Implications:

• Accurate identification of Lambl's excrescences via TEE is crucial for avoiding misdiagnosis.
• Understanding their typical appearance aids in differentiating them from clinically significant pathologies like vegetations or thrombi.
• This case serves as an educational example for clinicians interpreting echocardiographic studies.