Cardiovascular disease in the very elderly

摘要: Clinical and necropsy observations are described in 40 patients (29 women) aged 90 years older. The majority (21 [57%]) died during the 4 coldest months, 12 (30%), warmest months. At necropsy, 39 had ≥1 major cardiac abnormalities, most frequent being calcific deposits epicardial coronary arteries 37 (92%). In 28 (70%), 1 or more of was narrowed 76 to 100% cross-sectional area (XSA) by atherosclerotic plaques, an average 1.9/4.0 per patient: with clinical events compatible myocardial ischemia (angina pectoris infarction) 2.2/4 other 1.0/4.0. 36 patients, a histologic section examined from each 5 mm long segment arteries: 1,789 segments, only 6 ( Calcific were present aortic valve cusps 22 (55%), causing stenosis 2, mitral anulus 19 (47%), probably 1. Amyloid heart at least 9 patients; they grossly visible caused fatal dysfunction 4, microscopically 5, no dysfunction. Eight (20%) chronic congestive failure; 27 (69%) either history systemic hypertension blood pressure >140/90 Hg their final year life. Precordial murmurs recorded 25 (62%) patients—systolic 24 both systolic diastolic Data electrocardiograms available 30 patients: (40%) atrial fibrillation; (40%), abnormal axis; 12, complete bundle branch block; 1, criteria for left ventricular hypertrophy (despite increased mass 67%); low voltage. All fairly extensive atherosclerosis aorta, aneurysmal formation rupture 3. Five strokes, which 4. leg claudication. Two massive pulmonary emboli superimposed on obstructive disease. Thus, cardiovascular disease our but frequently it not diagnosed clinically.