Multiple Papillary Fibroelastomas

A 53-year-old woman who had a history of mitral valve prolapse was referred to our institution after an incidental finding of small masses on the mitral, tricuspid, and pulmonary valves on transthoracic echocardiography. She had no symptoms suggestive of endocarditis with negative blood cultures. Complete blood cell count and erythrocyte sedimentation rate were within normal limits.The patient underwent transesophageal echocardiography, which showed a pedunculated, papillary mass on the tricuspid valve (Figure 1 and Movie I in the online-only Data Supplement) with mild tricuspid regurgitation. In addition, 2 sessile masses were noted on the pulmonary valve (Figure 2 and Movie I in the online-only Data Supplement) and the posterior mitral …