Systemic thromboembolism in rheumatic heart disease

The results of 62 autopsies of patients with rheumatic heart disease have been analyzed. The patients were 14-56 years old (mean 26 years). Thirteen patients had evidence of systemic thromboembolism (STE). All 13 patients had renal infarction, 2 had cerebral infarction, and 1 had a splenic infarction. Only 1 case with cerebral infarct was diagnosed clinically. Seven of 30 patients with atrial fibrillation had STE as did 6 of 32 patients with sinus rhythm. The type of valve involved and previous commissurotomy did not positively correlate with STE. It was observed that in this selected group of chronically ill patients who were autopsied, the elderly male patients with atrial fibrillation demonstrated increased incidence of STE.