A clinicopathological study of the heart diseases in the aged. The morphological classification of the 1,000 consecutive autopsy cases.

Consecutive autopsy of 1,000 cases of the aged disclosed coronary sclerosis in 428 cases, myocardial infarction in 137, cardiac hypertrophy in 237, valvular heart disease in 120, conduction disturbances in 96, cor pulmonale in 41, pericarditis in 39, and congenital heart disease or anomalies in 28. There were 343 morphologically normal hearts. A total of 1,022 heart diseases were found in 657 cases, corresponding 1.6 heart diseases per one heart. Heart diseases in the aged were divided into (1) those continuing from the younger period and (2) those specifically found in the aged. The latter were non-inflammatory valvular diseases and chronic conduction disturbances. Mitral regurgitation, including mitral ring dilatation (10), mitral ring calcification (9), spontaneous rupture of the chordae tendineae (2) and calcified aortic stenosis (12) and degenerative aortic regurgitation of prolapsed cusp (35) were produced by various degeneration of the connective tissue of the valves. A total of 59 cases of conduction disturbances consisted of complete or advanced heart block (15), right bundle branch block (RBBB) (16), RBBB with left axis deviation (17), and left bundle branch block (LBBB) (11). Forty-seven cases showed main lesions in the branching portion of the AV bundle and origin of the bilateral bundle branches, which were closely related to the degeneration of the central fibrous body and fibrosis at the summit of the ventricular septum. The common field, where the valvular diseases and conduction disturbances occurred, was the fibrous trigone of the heart.