Chronic Rheumatic Heart Disease

Clinical History

This man had a history of rheumatic fever at age of 18. A mitral valvotomy was performed 7 years before his death at the age of 45. He was admitted with signs of congestive heart failure (raised jugular venous pressure, pitting oedema, hepatomegaly and basal crepitations.) On auscultation, there were systolic and mid-diastolic murmurs in the mitral area.

Pathology

The heart has been sliced transversely and mounted to display the mitral and tricuspid valves from above. The stenosed mitral valve has a thin crescentic orifice and the cusps are thickened and calcified. The aortic cusps show mild thickening and are partly fused. The tricuspid and pulmonary valve cusps are normal. Examination of the back of the specimen reveals both left and right ventricular hypertrophy. This is mitral stenosis due to chronic rheumatic endocarditis of the mitral valve.

Note

See Note, AH 3