Oldest Case of Heart Failure Found in Ancient Mummy

The oldest case of acute decompensated heart failure has been found in 3,500-year-old mummified remains, a research team announced at the international congress of Egyptology in Florence.

Consisting of just a head and canopic jars containing internal organs, the remains were found in a plundered tomb by the Italian Egyptologist Ernesto Schiaparelli in 1904 in the Valley of the Queens, Luxor, and are now housed at the Egyptian Museum in Turin.

They belong to an Egyptian dignitary named Nebiri, a "Chief of Stables" who lived under the reign of 18th Dynasty pharaoh Thutmoses III (1479-1424 BC).

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"The head is almost completely unwrapped, but in a good state of preservation. Since the canopic jar inscribed for Hapy, the guardian of the lungs, is partially broken, we were allowed direct access for sampling," Raffaella Bianucci, an anthropologist in the legal medicine section at the University of Turin, told Discovery News.

She investigated the mummified remains with researchers from the Universities of Turin, Munich and York.

Detailing the findings at the conference, Bianucci reported that Nebiri was middle aged - 45 to 60 years old - when he died and that he was affected by a severe periodontal disease with massive abscesses, as revealed by Multidetector Computed Tomography (MDCT) and three dimensional skull reconstruction.

The scans showed there was a partial attempt at excerebration (removal of the brain), but a considerable amount of dehydrated brain tissue is still preserved. Linen is packed in the inner skull, eyes, nose, ears, mouth and even fill the cheeks.

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The researchers also detected evidence of calcification in the right internal carotid artery, consistent with a mild atherosclerosis.

"We saw only a tiny fleck of calcium. Since the rest of the corpse is missing, it is impossible to establish whether there was calcification in other artery walls," she added.

Most interestingly, the histology of the lung performed by Andreas Nerlich, professor at the department of pathology at Ludwig-Maximilians-University in Munich, Germany, revealed the presence of "heart failure" cells. A pulmonary edema, which is fluid accumulation in the lungs's air sacs, was also identified.

"When the heart is not able to pump efficiently, blood can back up into the veins that take it through the lungs. As the pressure increases, fluid is pushed into the air spaces in the lungs," Bianucci explained.

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Since histochemical staining ruled out other possible diseases including tuberculosis, granulomas and acid-fast bacilli indicating mycobacterial infections, the researchers concluded that Nebiri possibly died from acute decompensation of chronic left-sided heart failure, which is a frequent consequence of chronic heart disease.

"Our finding represents the oldest evidence for chronic heart failure in mummified remains," Bianucci said.

Valvular disease, ischemia, metabolic disorders of the heart muscle, or chronic hypertension are among the causes for the disorder.

In Nebiri's case, the researchers believe chronic hypertension is the best candidate.

Currently, over 20 million people worldwide, mainly over 65, are affected by chronic heart failure.

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"A systematic analysis of canopic jar content could help establish whether the disease was more frequent in our ancestors or its prevalence increased in modern times," Bianucci said.

The elaborate mummification technique played a crucial role in diagnosing the cause of death, according to the researchers.

"The level of preservation is outstanding and easily equals the standard seen with royals of the time," Egyptologist Joann Fletcher, professor at the University of York's Department of Archaeology, told Discovery News.

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Chemical analysis of the compounds used to treat Nebiri's corpse revealed a relatively high quality of mummification.

"It was a complex mixture of an animal fat or plant oil, a balsam/aromatic plant, and non-native conifer resin and pistacia resin. The last three ingredients contain strongly antibacterial compounds, so would certainly have helped preserve his body and lungs," Stephen Buckley, an archaeological chemist at the University of York in England, told Discovery News.

Current research is now focusing on Nebiri's facial reconstruction, which is being carried out by Tobias Houlton and Christopher Rynn from the University of Dundee, UK.

Nebiri's mummified head at left and, at right, the broken canopic jar containing Nebiri's lungs.

A young, short man with a slight resemblance to Michael Jackson, a woman with an elaborate hairstyle and an older woman who could slip, unnoticed, into today's society -- all died some 2,000 years ago but now facial reconstructions of the ancient Egyptians have brought them back to life.

The reconstructions were unveiled today at McGill University's Redpath Museum.

"People are amazed by mummies, but never more so, I've found, when they can see the face," said anthropologist Andrew Wade of Western University.

The high tech process, involving CT scanning and multiple scientific disciplines, recreates what the three individuals looked like as they were laid to rest nearly 2,000 years ago.

Here, a mummy is set to go into a CT scanner.

Mummies of a young male, a young female and an older woman were virtually unwrapped using CT scanning. Models of their bone structure were then created.

Barbara Lawson, a curator at the Redpath Museum who also worked on the project, added that all three mummies were scanned at the Montreal Neurological Institute and Hospital as part of Western University's IMPACT Radiological Mummy Database Project.

Forensic artist Victoria Lywood undertook the actual reconstruction work, which was based on the 3-D high-resolution images along with ultrasonic images and anthropological research.

A step in the process involved sketching what the individuals would have looked like.

Some have detected a facial resemblance, at least from the front profile, with the late pop star Michael Jackson. Jackson was, in fact, very interested in Egyptian history, which might have influenced some of his personal style.

The Theban male died between the ages of 20-30. His mummy was purchased in Thebes, his likely place of death.

The young man was "relatively short in stature," according to Wade.

Lywood is one of the world's leading experts on such recreations.

"I reconstruct modern-day skulls, archaeological remains and fragmentary skulls," she told Discovery News. "The oldest I have constructed was from 6,000 years ago found in Israel. While there were people of all sizes throughout the ages, my experience is that skull size was much smaller than modern populations."

This Ptolemaic female was a "late adolescent girl or young woman of average height and elite status," Wade said. "Her age at death is estimated at between 18 and 24 years."

Her mummy was found "in a tomb pit in the solid rock near Hawara el-Makta in Fayum (Lower Egypt) and acquired in Egypt towards the end of the 19th century and donated to the Redpath Museum in 1895," Lawson said.

Clearly ancient Egyptians prized fashionable coifs, given the complexity of the young woman's hairstyle.

Her hair must have been fixed before mummification, perhaps in hopes of sending her off to the next life looking her best.

The hairdo of a young ancient Egyptian female was reconstructed on a modern woman.

The reconstructed young woman is shown here without her wig. Clearly her hair was a big part of her look.

The oldest individual of the three was this woman -- likely a tall, upper middle-class adult between the ages of 30 and 50 years old.

If she were alive today, this woman (at least based on her physical appearance) would probably fit right in with modern society.

As Wade said, "Humans have been physically pretty much the same for the last 2,000 years...That's not to say that evolution has stopped working on us, but the time frame of 2,000 years is just a drop in the bucket for noticeable physical changes and we've reduced the need for physical changes by adapting culturally."

The three ancient Egyptian people died at somewhat different times and never knew each other. But, as reconstructions, the early Egyptians will spend even more time together, because they will star in a new display in the Redpath Museum's World Cultures gallery starting in February.