HEART - Mitral stenosis and incompetence (probably rheumatic)

This is a heart in which the wall of the left auricle has been opened to display the mitral valve. The endocardium of the left auricle is thickened, and there is clot adherent to the interauricular septum (right side of jar). There is also blood clot in the auricular appendix (left side of jar), although one cannot see whether the clot is ante mortem or post mortem. The mitral valve is funnel-shaped. Although the valve orifice is narrowed, the valve is rigid and held open by both thickened chordae and its own distortion. Hence the valve is both is stenotic and incompetent. The history of this specimen is unknown, however the changes in the mitral valve are consistent with scarring secondary to past rheumatic carditis.