A clinicopathologic study on valvular diseases among 4,000 consecutive autopsies of the aged

Abstract

Among 4,000 consecutive autopsy cases over 60 years during past 17 years, there were a total of 485 cases (11.5%) with valvular heart diseases showing both clinical and pathologic evidences. The incidence of the valvular disease in the aged was aortic regurgitation (AR) in 204 cases (45%) and mitral regurgitation (MR) in 171 cases (37%), followed by aortic stenosis (AS) in 45 cases (10%), mitral stenosis (MS) in 27 cases (6%). As an etiology of the valvular disease, degenerative type was found in 195 cases (43%), ischemic origin in 91 (20%), followed by syphilitic in 56 (12%) and rheumatic in 49 (11%). Congenital origin was also found in 18 cases (4%). Among various types of valvular diseases in the aged, degenerative AR was most common in 140 cases, followed by MR due to papillary muscle dysfunction in 91 cases. The clinical characteristics in cases with valvular diseases were as follows: atrial fibrillation was prominent in MS; congestive heart failure was found in 60% of cases except those with degenerative AR; cardiac death was frequent in syphilitic and rheumatic AR; association of hypertension was found in 50% of cases with MR and degenerative AR.