Sub-aortic septal perforation associated with pulmonary and systemic embolism

The fourth case of septal perforation, in a 92 year old woman is reported. Interesting clinical and autopsy findings were the high diastolic and systolic murmurs. Paradoxic embolism or shorn dumb-bell clot caused her systemic and pulmonary embolism. Diagnosis is difficult, as Leatham's (1883) classic acquired VSD description does not hold (Summary)