Science and Education Publishing American Journal of Medical Case Reports 2 5 2014 05 19 Mystery of the Right Sided Heart Failure in a Young Patient 94 96 EN Gaurav Khandelwal Senior Resident, Department of Cardiology, SMS Medical College and Hospital, Jaipur, Rajasthan, India Manish Ruhela Rajeev Bagarhatta AJMCR2014251 10.12691/ajmcr-2-5-1 2014 04 14 2014 05 16 2014 05 19 A 45 yr old female presented with clinical features of right side heart failure. 2D Echocardiography examination showed a homogenous, irregular, fimbriated mass attached to pulmonary valve, causing right ventricular outflow obstruction, with severe tricuspid regurgitation. To the best of our knowledge, this is the first case report of pulmonary valve mass, possible papillary fibroelastoma, which is large enough to cause right ventricular outflow obstruction, leading to severe tricuspid regurgitation and right sided heart failure.