The illness and death of King George VI of England: the pathologists' reassessment

The illness and death of King George VI has received renewed attention based on the events portrayed in the Netflix blockbuster series, The Crown. The King, a heavy smoker, underwent a left total pneumonectomy in September 1951 for what euphemistically was called "structural abnormalities" of his left lung, but what in reality was a carcinoma. His physicians withheld this diagnosis from him, the public, and the medical profession. The continuation of hemoptysis following surgery suggested that his cancer had spread to his right lung. Although he made a slow and uneventful recovery from his surgery, King George VI died suddenly and unexpectedly in his sleep on February 6, 1952, at the age of 56. Since the King had a history of peripheral vascular disease, it was assumed that the cause of death was a "coronary thrombosis." In this report, we explore the cardiovascular and oncologic findings relating to his illness and death and consider an alternative explanation for his demise, namely, that he may have died of complications from a carcinoma that had originated in his left lung and spread to his right lung, as evidenced by continued hemoptysis. We suggest that this possibly could have led to his sudden death due to either a pulmonary embolus or a massive intra-thoracic hemorrhage rather than a "coronary thrombosis."