A 63-year-old man was seen with a history of nonfluent dysphasia and headaches. His blood tested positive for anticardiolipin antibodies. Transthoracic echocardiography showed a mass in the left ventricular apex. The transgastric five-chamber view identified this mass as an anomalously placed papillary muscle. In the presence of an apical mass, if the transthoracic echocardiogram is equivocal, a transesophageal echocardiogram, using the transgastric fixed-chamber view may be helpful in making the correct diagnosis.