Alveolar Walls in Mitral Stenosis

Pathologic alterations of alveolar walls in 95 autopsied patients with mitral stenosis were not frequent. The most frequently encountered change was capillary dilatation, and in 83 per cent of the patients, even this change was slight or absent. Other alterations were focal and involved only small proportions of the area of tissue examined. A generalized increase in the thickness of base-ment membranes could not be demonstrated. PATHOLOGIC changes in the pulmonary alveolar walls of patients with mitral stenosis have been described by many investi-gators.'-3 Among the changes described are fibrous thickening, capillary distention, thick-ening of the capillary basement membranes, and cuboidalization of the alveolar lining cells. It has been pointed out that such pathologic alterations, if widespread, could produce marked physiologic disturbances.4 However, our own observations on current autopsies of individual patients with mitral stenosis led us to suspect that advanced pathologic changes in the alveolar walls were almost always focal, rather than widespread. These observations stimulated us to review sections of the lungs from a large number of autopsied patients with mitral stenosis. The purpose of this study is to establish the extent and character of abnormal-ities of alveolar walls in 95 adult patients who died with mitral stenosis. MATERIAL AND METHODS Autopsy records and microsections were ex-amined from 95 patients with mitral stenosis as a principal anatomic diagnosis. These patients repre-sent a consecutive series of all such patients over 20 years of age, autopsied at Washington University during the period 1938 to 1954, from whom suitable material was available for study. Patients were chosen for inclusion in the study on the basis of objective anatomic findings. The average age of the patients was 47 years. A review of the clinical and autopsy records revealed tha