Woman in black: the cardiac ochronosis with severe aortic valve stenosis

(A) Accumulation of homogentisic acid in the tissues and destruction of the connective tissue (conjunctive–cornea–sclera). (B) Bluish–black discolouration of episclera in the interpalpebral area of both eyes. (C) Intraoperative findings: after the opening of the aorta, the bluish–black discolouration of the ascending aorta intima and the aortic root involving the aortic valve leaflets can be seen. (D) Excised aortic valve stenosis.