eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2023-06-29 11 5 98 100 10.12691/ajmcr-11-5-4 AJMCR20231154 article Jesus Romero je-romeros@hotmail.com 1 Sherif Elkattawy 2 Sohail Sodhi 2 Ana L. Romero 2 Omar Elkattawy 3 Rachel Abboud 3 Razan Shamoon 3 Fayez Shamoon 3 Internal Medicine Department, RWJBarnabas Health/Trinitas Regional Medical Center, Elizabeth, New Jersey, USA Cardiology Department, St. Joseph¡¯s University Medical Center, Paterson, New Jersey, USA Internal Medicine Department, Rutgers University-New Brunswick, Jersey City, New Jersey, USA Noonan syndrome is an inherited disorder that involves various organs, such as dysmorphic facial features, cardiac defects, and cryptorchidism, among others. Its pathophysiology is linked to germ-line mutations in the RAS/mitogen-activated protein kinase (MAPK) pathway. The most frequent cardiac defect in this syndrome is pulmonary valve stenosis. Conversely, mitral valve involvement is rare, and a parachute-like asymmetric mitral valve presentation is even rarer. In cases where surgery is necessary, mitral valve repair is preferred over mitral valve replacement. Here we present a case of a 20-year-old gentleman with Noonan syndrome who was found to have a parachute-like mitral valve evidenced by a 2D-Echocardiogram. http://pubs.sciepub.com/ajmcr/11/5/4/ajmcr-11-5-4.pdf Noonan syndrome MAPK pathway cardiac defects parachute mitral valve parachute-like asymmetric mitral