Enlarge Descriptive Card Log Book Entry (none)
Rodin Number: 16
E Number: none
Donor: Howard and Osler
Date: 1877
Size (H x W cm): 14.5 x 13.5
The specimen shows extensive left ventricular myocardial fibrosis (F) involving the lateral apex and (on the lateral view (B)) the posterior septal region. Mitral annulus calcification is evident (arrow on view (A)). The descriptive card indicates that there is complete occlusion of the right coronary. However, in a back view of the specimen (C) the vessel is moderately narrowed by atherosclerosis but clearly patent (short arrow).
Click on caption to enlarge image.
Comment
The autopsy findings of this case are discussed in Osler's Autopsy Protocol LXVII 1877 (
rodin_oslerian_pathology_212.pdf). Few clinical details are provided; however, the patient appeared to have cardiac failure, with pitting edema of the legs and peritoneal/pleural effusions. Myocardial fibrosis is clearly described: “ ...the inner half of the muscular wall of the ventricle... has lost its normal color & aspect, & is pale, almost white at least light grey.” Although he also describes aortic atherosclerosis, there is no mention of such disease in the coronary arteries.
The descriptive card states that the patient had a history of repeated anginal attacks extending over ten years; however, it also indicates that the patient was 60 instead of 65 as written in Osler's autopsy book. R. Palmer Howard was Professor of Medicine at McGill.