Len Fehskens wrote:

>I thought it was generally accepted that Mahler died of bacterial
>endocarditis and probably would have lived had penicillin been discovered
>sooner.

That's right.  He had subacute bacterial endocarditis caused by
streptococcus viridans and that is what killed him.  This infection of
the heart valves occurred because of previous damage to his mitral valve,
probably from rheumatic fever as a child.  His mitral valve disease was
discovered more or less by accident when a physician caring for his
daughter examined his heart as a way of getting the child to be examined in
1907.  This diagnosis and the doctors' restrictions (which only came from
a second opinion) on his long walks had a profound impact but the strep
infection that actually killed him began only six months before his death.
In fact between 1907 and 1910 his workload as a conductor was immense and
his health, apparently, OK. The fatal endocarditis was confirmed in early
1911 both by clinical exam and by blood cultures.

The angina referred to already, I have been told, could have been what
was known then as "Ludwig's angina": a serious throat infection and not
a heart condition at all.

Tony Duggan, England.
Mahler recordings survey:
http://www.musicweb.force9.co.uk/music/Mahler/