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A 47-year-old female admitted to our hospital with exertional dyspnea and cerebral thromboembolism. There was no history of rheumatic fever. The chest roentgenogram showed marked cardiomegaly with pulmonary congestion. Ultrasound cardiogram showed mitral valve incompetence and abnormal echo shadow in the left atrium. Left ventriculogram revealed grade 3 mitral regurgitation. At operation, a 5-cm anomalous chordae tendineae was attached to the left atrial wall through the mitral orifice. The mitral valve showed thickening of the leaflets and fusion of the posterior commissure. The mitral valve was replaced with a mechanical prosthesis. The patient has been doing well after her surgery.
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