Mitral valve stenosis in the elderly

Forty-seven elderly patients (aged 70-95 years) with mitral stenosis (MS) were studied. The initial presentation in 77% of patients was in the postretirement age and 55% were diagnosed after the age of 70 years. A history of acute rheumatic fever (ARF) was given by 43% of all patients. One patient had mitral valve stenosis secondary to mitral annular calcification. MS due to rheumatic heart disease may be mild or the progress may be slow enabling patients to live a near normal life; increased longevity of the population in general, use of potent diuretics, limitation of physical activity due to medical complications and decreased number of pregnancies may have been contributory factors. In 23% of patients the diagnosis was initially unrecognized, underlining the possible occult nature of the valve lesion in some elderly patients. The advent of echocardiography has helped in case detection.