The problem of embolism and peripheral venous thrombosis has always been a major one in the treatment of heart disease and particularly of coronary heart disease. This is due to the prevalence of mural thrombi in the chambers of the heart, which may serve as a source of emboli, and to the occurrence of peripheral venous thrombi, especially in the legs. Several articles on the subject have appeared in the literature of the last few years, a splendid summary of which is given by Hellerstein and Martin,1 who also give their own observations in 160 cases of myocardial infarction occurring in a total of 2,000 autopsies at the University Hospitals in Cleveland. In 45 per cent of the cases in their series there were emboli or thrombi in other parts of the body, a total of one hundred and eleven peripheral thromboembolic lesions being found. In 12 per cent of the cases these were the main cause of death, and in another 15 per cent they were contributory causes of death. In a series of 1,146 autopsied cases collected by the aforementioned authors from the litera¬ ture up to 1947, the location of thromboembolic lesions following myocardial infarction was : lung, 23.5 per cent ; brain, 7.7 per cent ; extremities, 5.5 per cent ; kidney, 14.4 per cent; spleen, 8.8 per cent, and mesenteric vessels, 1.9 per cent. These figures include all the lesions encountered and do not, of course, represent the number of patients involved, since many showed embolism in more than one organ. Of these, pulmonary embolism is the commonest serious compli¬ cation of cardiac infarction and in the foregoing sum¬ mary was the chief cause of death in 10.6 per cent of autopsied cases.Also in 1947, Mintz and Katz,2 in a clinical analysis of 572 cases of recent myocardial infarction, found a total incidence of 52 cases of thromboembolism, of which 28 were pulmonic and 13 cerebral. In a series, as yet unpublished, of 1,000 cases of recent myo¬ cardial infarction at the Los Angeles County Hospital, Edmondson 3 observed a total of three hundred and twenty-eight manifest embolisms in some part of the body outside of the heart, and of these one hundred and sixty-one were in the lungs, forty-eight in the brain, ten in the mesenteric vessels and twenty-eight in the extremities.Most of the preceding autopsy material was reported from major cities and included a considerable per¬ centage of patients from public hospitals. With the idea in mind of summarizing the material of a smaller hospital, in a relatively small city, nearly all of the patients of which were private, the following study was made of the autopsy records of the Huntington Memorial Hospital. The autopsy percentage has remained about 65 per cent over the course of years.Since the city of Pasadena has a large proportion of persons of middle age and older, the problem of coro¬ nary heart disease is a major one. A review is made of a total of 3,900 autopsies done from January 1931 to May 1948. Of these 727 were in newborn or still¬ born infants, leaving 3,173 in older than newborn sub¬ jects. Few chi...
