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April 1969

Retinal Embolism From Calcified Vegetations of Aortic Valve: Spontaneous Complication of Rheumatic Heart Disease

Author Affiliations

USA; Washington, DC
From the Department of Ophthalmology, Walter Reed General Hospital (LTC R. Penner) and the Registry of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC (Dr. Font).

Arch Ophthalmol. 1969;81(4):565-568. doi:10.1001/archopht.1969.00990010567018

EMBOLI to the retinal arterial system can be classified on the basis of the nature of the embolic material. The purpose of this report is to demonstrate the gross and histopathologic appearance of a calcific embolus observed ophthalmoscopically in a retinal arteriole prior to the patient's death.

Report of a Case 

Clinical History.  —The patient, a 45-year-old white woman, had had rheumatic heart disease since the age of 9, with recurrent episodes of acute rheumatic fever at ages 22 and 30. She was otherwise asymptomatic until age 44, when she developed congestive heart failure. Initially this was well controlled, but during the following year her cardiac status deteriorated, and she was admitted to Walter Reed General Hospital because of marked shortness of breath.On physical examination a diagnosis of rheumatic heart disease with aortic insufficiency and congestive heart failure was made. Roentgenographic studies revealed cardiomegaly with left ventricular hypertrophy