Pathology of infective endocarditis. A postmortem evaluation.

A review of 28 necropsy cases of infective endocarditis seen over the 12-month period of I969 is presented. The infection involved a previously apparently normal valve in I6 cases (57%). Isolated aortic valve endocarditis was the commonest lesion and wasfound in i5 cases. Infective endocarditis of the aortic valve characteristically occurred on a nornal valve in middle-aged men. In the IO cases of isolated mitral endocarditis evidence of previous abnormality, rheumatic disease or endomyocardial fibrosis, was usually present. Blood cultures in life had been positive in only 3 of the total series and were repeatedly negative in 8. Postmortem bacteriology of the vegetations was positive in 13 out of I9 cases so studied. Death had occurred within 2 weeks of the onset of illness in I4 cases (5o%). The histopathology frequently showed focal myocardial scars and smaller coronary artery changes in the absence of evidence of coronary embolism.