By F. I. Caird, R. D. Kennedy (auth.), F. I. Caird, J. L. C. Dall, R. D. Kennedy (eds.)
As sturdiness raises, the scope of cardiac problems extends extra extensively within the 6th decade and onward into the 7th and subse quent a long time. for instance, due to potent cardiac surgical procedure in adolescence, congential middle affliction is now chanced on with expanding frequency in adults and never incredibly in people over sixty five years of age. The frequency of aortic valve substitute for calcific congenital valve stenosis in topics round 70 years of age illustrates the intrusion of congenital middle affliction into the older age variety. therefore, the publica tion of Cardiology in previous Age could be specifically welcome at the present. The Editors have assembled an impressive galaxy of specialists to offer the specific difficulties of epidemiology, pathology, cardiovascu lar body structure and serve as, and of particular cardiac problems within the aged. The bankruptcy on cardiac surgical procedure is especially acceptable to many present difficulties. the entire topic needs to be of transforming into main issue to all clinicians and medical examiners who've more and more to accommodate older sufferers who've cardiovascular problems. wisdom of the consequences of getting older at the cardiovascular process is accordingly of significant curiosity and the data given during this e-book absolutely could be of worth to normal physicians and cardiologists, who could be anticipated sooner or later to paintings extra heavily with geriatricians within the care of the aged. carrying on with examine into the issues of getting older is obviously additionally of serious value particularly within the box of cardiovascular medicine.
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Extra resources for Cardiology in Old Age
The combination of these Fig. 20. Mucoid degeneration of mitral valve, seen from the left atrium. Both cusps are expanded, thick, and white, and prolapse into the atrial cavity. A ruptured chorda tendina can be seen (arrow). From an elderly man with "irregular heart" for 2 years, who died suddenly. Only minimal coronary atheroma was present. 38 Ariela Pomerance friction lesions with clearly abnormal mitral cusps may lead to an erroneous diagnosis of rheumatic valve disease by those unfamiliar with mucoid degeneration.
An increased incidence has been noted in diabetes mellitus (Kirk and Russell 1969), osteitis deformans, (Harrison and Lennox 1948), and hypertension (Kirk and Russell 1969, Pomerance 1970), and the mitral ring is one of the sites affected by metastatic calcification. No abnormal calcium metabolism has been demonstrated in most cases, however, and the condition is generally accepted as an exaggeration of normal aging changes. The reason this should occur in only a minority of elderly patients and particularly in women remains obscure.
Only minimal coronary atheroma was present. 38 Ariela Pomerance friction lesions with clearly abnormal mitral cusps may lead to an erroneous diagnosis of rheumatic valve disease by those unfamiliar with mucoid degeneration. l. Microscopically, areas of loose, spongy tissue are seen replacing the normal dense collagen of the cusp fibrosa, and may also be seen in the chordae tendinae (Fig. 23). The anatomical layers of the cusp Fig. 21. Mucoid degeneration with rupture of chordae tendinae. The lateral half of the posterior mitral cusp shows ballooning deformity, and two chordae are ruptured (arrow).