Abstract
A case which exhibited eleven endocardial pockets of the left atrium secondary to chronic rheumatic mitral insufficiency is presented. The endocardial pockets consisted of thickened endocardial folds which usually had a semilunar contour. The concavity of the pockets was directed toward the apex of the heart. The pockets were composed of masses of smooth muscle cells and elastic and collagenous tissue in orderly arrangement and arose from the superficial portion of the endocardium. There was no vascularity, cellular exudate, or pigmentation of the endocardial pockets or surrounding endocardium. Prolonged regurgitation of blood and the resulting pressure are the most significant factors in the development of endocardial pockets.
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