A 69-year-old male patient admitted to the hospital with congestive heart failure. Physical examination presented signs of left heart failure, and cardiac auscultation disclosed a grade III/VI pansystolic murmur at the apex. Transthoracic echocardiography showed a large saccular bulge originating from the anterior mitral valve leaflet with severe mitral regurgitation, and multiple valvular and subvalvular vegetations (Figure 1). Transesophageal echocardiography confirmed the diagnosis of complicated endocarditis of the mitral valve with large ruptured anterior mitral valve leaflet aneurysm (2.2 × 2.5 cm) producing severe mitral regurgitation (Figure 2). Aortic valve was clear of vegetations although it presented with mild to moderate aortic regurgitation. Blood cultures were positive for coagulase negative staphylococcus. A few days later, the patient underwent cardiac surgery for mitral and aortic valve replacement. The patient completed a 6-week antibiotic regimen following surgery and was then successfully discharged with no signs of heart failure.