The patient was a boy of 12 with a history of chorea at 3. He suffered from frequent sore throats and developed fever, malaise and joint pains. Both systolic and diastolic murmurs were heard in the mitral area. He died of bronchopneumonia.
The heart is sliced to display the left atrium, mitral valve and left ventricle. The left ventricle is dilated and the myocardium and papillary muscles are hypertrophied. A row of small uniform vegetations is present along the line of contact of the mitral valve cusps. The posterior chordae are shortened. In addition to these signs of rheumatic endocarditis, the visceral pericardium on the back of the specimen has lost its sheen, evidence of the presence of rheumatic pericarditis.