William Osler and his Gulstonian Lectures on malignant endocarditis.

Current perceptions of the association between William Osler and bacterial endocarditis are, for many of us, encompassed by the eponym, "Osler's nodes." Osler himself credited others with priority in description of those nodes, and the eponym is justified only because it signals the overlordship of the disease that the great clinician maintained for 3 decades (1885 through 1915). In the Gulstonian Lectures on malignant endocarditis, Osler provided, as Cushing said, "the first comprehensive account in English of the disease and did much to bring the subject to the attention of clinicians." In the present account, I have sought to assess the degree to which Osler's contributions to knowledge and understanding of bacterial endocarditis were extended or limited by forces of time and circumstance that, for the most part, extended beyond boundaries that any effort on his part could have altered.

Cardiac papillary fibroelastomas. Two-dimensional echocardiographic recognition.

Papillary fibroelastomas are benign tumors of the heart and are most often incidental findings at cardiac surgery or autopsy. Rarely, symptoms or even sudden death can occur. We report two cases of cardiac papillary tumors diagnosed by two-dimensional echocardiography and successfully excised. One patient was asymptomatic and had a 1-by 1-cm papilloma of the mitral valve. The other patient had intermittent chest pains and diaphoresis associated with a 1.5- by 1-cm aortic valve papilloma.