The specimen is a mitral valve. The aperture has a characteristic "fish mouth" appearance. The
valve leaflets are fused. Vegetations are present underlying the antero-lateral commissure,
extending onto the chordae tendineae.
The patient was admitted with a history of diarrhoea and headaches. Blood cultures were
positive for Streptococcus viridans and antibiotic therapy was commenced. Fever persisted for
some time and echocardiography revealed involvement of the mitral valve. She underwent mitral
valve replacement and made an uneventful recovery.