Congenital mitral insufficiency caused by anomalous mitral arcade in an elderly patient: use of echocardiography and multidetector computed tomography for diagnosis.

Anomalous mitral arcade is a rare congenital malformation and few survive to adulthood. A 65-year-old man presented with mild dyspnea and cardiac murmur. Transthoracic and transesophageal echocardiography showed an arc-like configuration of the papillary muscles, constrained by an interconnecting fibrous band in direct continuity with the anterior mitral leaflet, and mitral insufficiency caused by the restricted mobility of the mitral valve. Multidetector computed tomography confirmed these findings.