Korean Circ J. 2010 Dec; 40(12): 611–613.
Published online 2010 Dec 31. doi: 10.4070/kcj.2010.40.12.611
PMCID: PMC3025332
Infective Endocarditis and Phlebotomies May Have Killed Mozart
Abstract
Thirty-five
year-old Amadeus Mozart died in Vienna after an acute illness that
lasted only 15 days but no consensus has been reached on the cause of
his death. From many letters written by his farther it is almost certain
that he experienced at least three episodes of acute rheumatic fever
attack in his childhood, and a relapse of rheumatic fever was suggested
to have killed Mozart, although death from acute rheumatic fever is very
rare in adults. His last illness was characterized by high fever,
massive edema, vomiting and skin rash. His last illness can be explained
by infectious endocarditis and heart failure. During his last hours, he
was given phlebotomy, possibly for the third time in two weeks, and
soon after he became unconscious and died. As such, phlebotomy performed
on a man dehydrated by high fever and vomiting may have caused systemic
shock. In summary, Mozart probably died from chronic rheumatic heart
disease complicated by infective endocarditis and heart failure, and
repeated phlebotomy-induced hypovolemic shock.
Keywords: Infective endocarditis, Bloodletting, Hypovolemic shock
Introduction
Wolfgang
Amadeus Mozart died on 5 December 1791 after having suffered 15 days of
acute and mysterious illness. After his death, his doctor, Franz
Closset, made the diagnosis of "hitziges Frieselfieber" (acute or severe
miliary fever) which was a common diagnosis made on patients with fever
and skin rash at that time. There was no reason to suspect any foul
play and autopsy was not performed.
Seventeen
ninety-one was one of Mozart's most productive years and he led an
active life traveling widely and conducting his music, but became
bed-ridden only 15 days before his death. The last days of Mozart was
described by Sophie Heibel, Mozart's sister in-law, to Nissen who was
writing Mozart's biography and ultimately married Mozart's widow.1)
In her letter to Nissen, Heibel described "when the doctor was called
in, he bled Mozart and put cold compresses on his burning head,
whereupon his strength declined rapidly and he fell unconscious and
never came around again".2) Indeed, Mozart died 2 hours after being bled. However, no consensus has been reached on the cause of Mozart's death.
