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22 - Heart: Subacute infective endocarditis

EnlargeÌýÌýÌýÌýÌý Descriptive CardÌýÌýÌýÌýÌý  Log Book Entry (none)

Rodin Number: 08
E Number: none
Donor: Molson and Osler
Date: 1881
Size (H x W cm): 9 x 8.5

The specimen shows a portion of the left atrium and attached mitral valve, the latter with multiple small vegetations on its leaflets.

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B
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C

Click on caption to enlarge image.

Comment

The descriptive card indicates that the specimen came from an 11 year-old boy who had presented with chorea and died about two weeks later. The case was presented at the Montreal Medico Chiurgical Society and reported in the Canada Medical and Surgical Journal (1881, 9:650 – 653) by W. A. Molson, a physician at the Montreal General Hospital. Osler had performed the autopsy which, in addition to the mitral valve vegetations, showed infarcts in the kidneys, spleen and brain. Although the descriptive card undoubtedly refers to the published case, the description of the valve in Molson's report indicates much larger vegetations than those seen in this specimen - "...numerous large vegetations were seen springing from the auricular edge of the segments ... those attached to the anterior curtain were the largest, and projected considerably beyond the margin of the valve ... (and) ... must have considerably impeded the flow of blood from the auricle." Thus, there is some doubt whether this is the specimen to which Osler and Molson refer.

As with some other specimens in the collection, the metal holder which supports the descriptive card has been mounted on the back of the specimen jar instead of the front (A). Ironically, the irregular tissue adhesions created during dissection resemble the vegetations of endocarditis (to the extent of being indicated by an arrow by Rodin) and the back view thus resembles the real disease (B). This error was presumably committed when the specimens were being restored, possibly as early as 1935 when they were remounted in square jars.

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