Adolescent male with aortic valve mass

An adolescent male with a history of dilated cardiomyopathy presented for routine follow-up. He had shown significant clinical improvement with normalisation of cardiac function on guideline-directed medical therapy and was currently asymptomatic (New York Heart Association Class I). He denied any febrile illness. Vitals were stable: temperature 98°F, heart rate 77 beats per minute, blood pressure 110/46 mm Hg and oxygen saturation 100% on room air. Body mass index: 14.72 kg/m 2. Physical examination was notable for a high-pitched, early diastolic decrescendo murmur.