Cardiac vegetation in neonatal CINCA syndrome. Echocardiographic long axis parasternal view of the right ventricular outflow tract. The pulmonary valve is closed and a thin posterior leaflet is clearly visible (white arrow). The anterior leaflet is thicker and a hyperechogenic lesion (white arrow head) is attached to its ventricular side. (LV: left ventricle; PA: pulmonary artery trunk; RV: right ventricle).