A man in his 60s with a history of metastatic prostate carcinoma, calcified bicuspid aortic stenosis, and aortic valve replacement 17 years ago presented to the emergency department with increasing shortness of breath. An outpatient cardiac electrocardiogram-gated computed tomography (CT) showed normal coronary arteries with a small, irregular perivalvular mass at the leaflet hinge point and reduced leaflet mobility, suggestive of obstructive valve thrombosis (Figure, A). Acute thrombolytic therapy was administered without any complications. Follow-up cardiac CT 3 days later showed normal leaflet motion and resolution of the thrombus (Figure, B). The patient was discharged with an adjusted anticoagulation regimen.