A clinicopathological study on valvular diseases in 1,000 consecutive autopsy of the aged.

The purpose of this report is to examine the incidence and etiological classification of the valvular heart diseases in the aged. Among 1, 000 consecutive autopsy, a total of 122 cases (42 men and 80 women) was clinically diagnosed as having valvular disease, who were the subjects of this study. Their ages ranged from 60 to 100 with an average of 78.7 years.Incidence of valvular disease was 12.2% (122 among 1, 000 cases). Ten cases (8.2%) of mitral stenosis (MS) consisted of 8 cases of rheumatic MS and 2 mitral ring calcification. Thirty-nine cases (32%) of mitral regurgitation (MR) included 28 cases of papillary muscle dysfunction, 4 ruptured chordae tendineae, 4 mitral valve prolapse, 2 mitral ring calcification, and 1 rheumatic etiology. Aortic stenosis (AS) was found in 10 cases (8.2%), consisting of 7 calcified, 2 rheumatic, and 1 congenital (discrete subaortic) stenosis. Aortic regurgitation (AR) was found in 59 cases (48.3%), including 48 degenerative, 8 syphilitic, 1 rheumatic origin, and 2 of unknown aortitis. There were 4 cases (3.3%) of tricuspid regurgitation (TR). Subjective symptoms were present in 64.8%. Incidence of congestive heart failure was 54%, cardiac death 37%, atrial fibrillation 37%, and hypertension was found in 59%.Combining the previously reported 120 cases and present 122 cases of valvular disease among 2, 000 consecutive autopsy, following conclusions were obtained. (1) Incidence of valvular disease was 12.1%. (2) Valvular heart disease included 18 cases of MS (7.4%), 76 MR (31.4%), 22 AS (9.1%), 122 AR (50.4%), and 4 TR (1.7%). (3) High incidence of MR and AR was noted in the aged, which were mainly related to papillary muscle dysfunction (58% of MR) and degenerative AR (68% of AR), respectively.