A 53-year-old male patient presented to Mayo Clinic in Rochester (MN, USA) in February, 2022, with chest pain. He had an abnormal stress echocardiogram, prompting coronary angiography that revealed severe multi-vessel coronary artery disease. A transthoracic echocardiogram (TTE) incidentally noted a pedunculated mass with stalk-like attachment to the right coronary cusp of the aortic valve measuring 2·5 cm in diameter (figure, A). No history of cardioembolic phenomenon was noted. Infectious workup was negative.