Apical 4 chamber echocardiogram showing vegetations on the mitral valve in patient with endocarditis

The apical four chamber views from the transthoracic echocardiography show bulky vegetations on the mitral valve (arrows). These images have been captured digitally and are displayed in quadrant screen format. In spite of insensitivity for smaller vegetations, precordial imaging is often effective for the purpose of imaging vegetations.