The echocardiogram for this patient presented a left atrium of moderate to severely excessive size with anechoic content. No evidence of “smoke” or thrombotic activity was noted. The atrial septum was deviated toward the right atrium without evidence of dilation or contraction. The LA/AO ratio was moderate to severely excessive for this patient at 2.73. The cranial and caudal mitral valve leaflets demonstrated mildly vegetative contour with prolapse of the cranial leaflet. Mitral valve regurgitation was noted with a jet of 6.67 m/sec. End point to septal separation was within normal limits as the cranial leaflet came in contact or adequately close to the ventricular septum upon systolic motion. The left ventricle demonstrated prominent volume, normal septal and free wall diastolic thicknesses, and papillary integrity. Ventricular function was deemed adequate to hyperdynamic expressed by the fractional shortening measurement of 52.87%. No inconsistencies were revealed regarding the presence of an aortic body tumor or chemodectoma. The right auricle appeared irregular. A small amount of echogenic pericardial effusion was noted which would suggest hemopericardium. Echogenic pericardial effusion in the presence of severe chronic left atrial enlargement and MR is suggestive of a left atrial tear. The tricuspid valve was found to be mildly vegetative and insufficient with a jet of 2.31 m/sec.