The echocardiogram presented a prominent right heart with mild right ventricular hypertrophy without clinically significant tricuspid regurgitation, and normal right atrial size. Severe tricuspid insufficiency was noted at 5.12m/sec. This is consistent with severe pulmonary hypertension. The patient is at high risk for sudden death. No evidence of neoplasia was noted in the right auricle, or elsewhere in the heart. The pulmonary artery was uniformly prominent with mildly depressed pulmonic velocity measured on PW Doppler. The mitral valve presented vegetative contour and was visibly insufficient on PW and color flow Doppler. Severe mitral insufficiency was noted at 4.9 m/sec. The left atrial size was enlarged and there an aortic body tumor that measured 2.8 cm. This impinged into the left atrium. The left ventricular outflow demonstrated normal flow patterns and velocities through the aortic valve.