MOST of the attention given to rupture of the chordae tendineae of the mitral valve has been accorded those instances which occur during the course of acute or subacute bacterial endocarditis, or which result from severe external violence to the chest. Frew1 described a case in which rupture of the mitral chordae tendineae took place during a prolonged attack of acute rheumatic fever; and Frothingham and Hass2 have reported an instance of spontaneous rupture of mitral chordae which were apparently not the site of previous disease.
In the last 2,400 autopsies at the Peter Bent Brigham Hospital, there were eleven instances of rupture of the mitral chordae tendineae. Four were associated with bacterial endocarditis involving this valve. The other seven patients presented no evidence of bacterial endocarditis and no history of severe trauma to the chest, but the mitral valves and their chordae tendineae showed scarring, calcification, or