Extreme mechanical aortic valve dehiscence: “Rocking motion” clearly assessed with echocardiography and fluoroscopy

A 19-year-old man was admitted due to sudden onset and progressively increasing shortness of breath, cough, nausea, and vomiting. The patient had undergone aortic and mitral valve replacement with mechanical prosthesis for the treatment of infective endocarditis 4 years ago. The patient had poor general condition with a body temperature of 37.4°C, blood pressure of 120/40 mm Hg, heart rate of 120 bpm, and respiratory rate of 32/min. Cardiac auscultation showed a grade 3/6 early diastolic murmur along the left sternal border