Incidence of Murmurs in the Aging Heart

Self Cite

Aortic systolic murmurs and aortic dilatation were studied in a randomized sample of 100 hospital patients over the age of 60. Clinical, phonocardiographic, radiologic and carotid-pulse data provided the basis for graphic characterization of the murmurs. Senile aortic dilatation was common (66 patients). In a high percentage (39 patients), dilatation of the ascending aorta (and sometimes of the arch) was associated with an aortic systolic murmur. The "innocent" type was always associated with aortic dilatation. This "innocent murmur of the aged", even though caused by structural alterations, should be considered in the same light as the "innocent murmur of children", as it is not associated with dynamic embarrassment of the circulation.

Section: Discussionsupporting

confidence: 93%

Importance of Aortic Dilatation in the Genesis of the Innocent Systolic Ejection Murmur of the Aged

Vittal¹,

Luisada²,

Rao

1976

Self Cite

“…Ejection sounds arising from the aortic root account for some basal systolic murmurs in the elderly, since dilatation of the aortic root and hypertension promote ejection sounds 15 . Perez et al 12 attributed systolic murmurs in their group to this mechanism, and perhaps ejection sounds make up some of our basal systolic murmurs that were unaccompanied by echographic evidence of aortic sclerosis.…”

Section: Resultsmentioning

confidence: 84%

“…In the only prospective, noninvasive study published to date of which we are aware, Perez et al 12 examined 100 patients over the age of 60 from a geriatric hospital. Subjects with evidence of infarction, cardiomegaly, obvious valvular and congenital heart disease, arrhythmias, and conduction abnormalities had been excluded.…”

Section: Resultsmentioning

confidence: 99%

Degenerative Calcific Valvular Disease and Systolic Murmurs in the Elderly

Wong

Shah²

1983

By use of echocardiographic and radiologic imaging, a prospective study was made of 98 elderly men, 65 to 102 years old, to define degenerative calcific valvular disease (DCVD)--its prevalence, morphologic features, functional significance, and relationship to systolic murmurs in the elderly. DCVD was diagnosed in 74 per cent of the group and murmurs were detected in 55 per cent, the incidences increasing with age. Fibrotic and calcific change of the aortic valve was the most common abnormality, occurring alone or together with alteration of the mitral valve. The murmurs were characteristically early systolic, of low intensity and medium pitch, and heard at more than one area. Of the group with valve degeneration, only 7 per cent was judged to be functionally significant and no more than moderate. It was concluded that DCVD is the cause of most systolic murmurs in the elderly and is usually hemodynamically unimportant. Echocardiographic criteria are important in identifying those subjects with possibly significant valvular dysfunction requiring invasive study.

“…For example, a systolic ejection murmur is not uncommon in the elderly. Perez 4 noted a significant heart murmur in 30 per cent of well elderly patients. For this reason, a systolic ejection murmur in the elderly is not given the same clinical attention as in younger persons.…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Replacement in the Elderly

Santinga¹,

Flora²,

Kirsh³

et al. 1983

In order to determine the risk of aortic valve replacement in the elderly, 77 patients over the age of 60 who had undergone this procedure were reviewed. Hypothermic-hyperkalemic cardioplegia was used in all patients. In 55 patients with isolated aortic valve replacement there were three deaths (5.5 per cent). In the entire series of 77 patients there were 13 deaths (13 per cent). In seven patients of an organ other than the heart. In only two patients did the operative death have a myocardial cause. Ninety-two per cent of the patients were in functional class I or II following surgery. Patients should come to surgery before reaching class IV. Aortic valve replacement can be carried out safely in the elderly, and the indications should be the same as for younger patients.