Image of the month: Rapidly evolving mitral stenosis: an unusual case of endocarditis.

A 72-year-old woman was admitted with increasing dyspnoea. She had a background of mitral regurgitation, atrial fibrillation (for which she was anticoagulated with apixaban), chronic obstructive pulmonary disease and primary hyperthyroidism. Computed tomography revealed an 11 mm sub-pleural nodule