A 46-year-old man with a medical history notable only for schizophrenia was admitted to hospital with complaints of general fatigue and high fever. Transthoracic echocardiography on day 6 after admission demonstrated a large vegetation (17 mm) on the anterior leaflet of the mitral valve with mild regurgitation and mild aortic regurgitation. The patient also complained of abdominal pain. Abdominal computed tomography showed a remarkable enlargement of the superior mesenteric artery aneurysm (SMAA). An excision of the SMAA and double valve replacement was performed, and the patient was administered a six-week course of intravenous antibiotic therapy.