This specimen is very old. The heart has been opened to display an extensive verrucous growth on
the left auricular wall, with discrete nodules on the mitral valve cusps. The appearance of the mitral
valve suggests stenosis (there is some shortening and thickening of the chordae and the valve cusps
appear thickened). There is an infarct in the spleen and another one in the lower pole of the kidney.
The renal infarct has a typical wedge shape characteristic of vascular occlusion, in this instance by
emboli from the vegetations in the left heart.