PATHOLOGY AND PROGNOSIS OF AORTIC-STENOSIS IN THE ELDERLY

Current results of the surgical treatment of aortic stenosis are grati fying. However, establishing the diagnosis of aortic stenosis in elder ly patients can be difficult. First, systolic murmurs are a common fin ding in the elderly, and their potential significance in patients with angina, heart failure or spells of dizziness or lightheadedness may b e underestimated. Second, calcific aortic stenosis in the elderly diff ers clinically and morphologically from typical aortic stenosis. Fortu nately, the use of Doppler echocardiography has greatly enhanced our n on-invasive diagnostic capabilities in recent years. A third important issue is the use of balloon valvuloplasty to relieve aortic stenosis; this technique has been applied successfully in congenital forms of a ortic and pulmonic stenosis, as well as in rheumatic mitral stenosis, and its appropriate use in the management of calcific aortic stenosis in elderly patients warrants discussion.