The left side of the heart has been opened to reveal a thickened left ventricular wall. The degree
of mitral stenosis and incompetence is difficult to measure but the mitral valve (particularly the
antero-medial cusp) is thickened and contracted with some thickening of the chordae.
Approximately half of the left auricle is occupied by organising thrombus.
This woman died at the age of 67. She was known to have mitral stenosis and
incompetence. Four years before her death she suffered an embolic episode with transient right
hemiplegia. There was a further hemiplegic episode two years and one year before death. A few
days before death she lost consciousness and did not recover. At autopsy, the heart weighed 520g.
The right kidney showed multiple infarcts. There were small infarcts in the right cerebral
hemisphere and in both of the occipital lobes, and there was a large area of necrosis in the
distribution of the left middle cerebral artery.