HEART - Rheumatic valvular disease

The aortic cusps are markedly and irregularly thickened with calcified excrescences on both surfaces; there is partial fusion of the antero-lateral and antero-medial cusps and the valve is appears to be both stenotic and incompetent. The muscle of the left auricular wall is thickened as is the endocardium. The cusps of the mitral valve are irregularly thickened as are the chordae, and there is partial cusp fusion. The mitral valve is less severely affected than the aortic valve. Both ventricles are hypertrophied.
This young man died suddenly with a known history of rheumatic heart disease. At autopsy his heart weighed 850 grams and the liver showed marked changes of chronic venous congestion.