Rheumatic Heart Disease in Patients Over Sixty Years of Age

Rheumatic Mitral Valve Disease in the Elderly

“…The series is only a small one, but this figure does not support the theory that late onset of rheumatic fever is a factor in the survival of people with rheumatic heart disease until old age. Appel and Kossmann (1951) found that the average age at onset of rheumatic fever was 21.5 years in their series of 71 patients. This contrasts with the natural history of the disease as described by Cohn and Lingg (1943).…”

“…Neptune, W. B., and Bailey, C. P. (1954) The incidence of mitral valve disease in elderly patients is much higher than is commonly realized. Some clinical studies-for example, those of Baker and Musgrave (1947), Cookson (1949), Kaufman and Poliakoff (1950), Appel and Kossmann (1951), and Hebbert and Rankin (1954)-have emphasized the relatively large number of cases of mitral valve disease in elderly patients. Hammond and Platts (1960) have drawn attention to the numbers of patients over the age of 60 who were found at necropsy to have mitral valve disease.…”

“…Horns (1944) found hypertension in 31 % of his patients over the age of 45; Baker and Musgrave (1947) found 38 % in patients over the age of 50. Appel and Kossmann (1951) gave a lower figure of 12.6% in 71 cases; Boas and Fineberg (1926) found 52.1% in 46 patients over the age of 50. Levine and Fulton (1928) found a bloodpressure greater than 150/100 in 58% of patients over the age of 45 and have emphasized the frequency of hypertension in older patients with mitral stenosis.…”

Incidence of Mitral Valvular Disease in the Elderly

“…There have, however, been several reports of the occurrence of mitral stenosis in elderly patients after rheumatic disease many years previously (White and Bland, 1941;Cookson, 1949;Appel and Kossmann, 1951 ;Hebbert and Rankin, 1954;Johnson, 1959).…”