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Idiopathic hypertrophic subaortic stenosis in the elderly
The American Journal of the Medical Sciences
|September 1, 1977
Summary
Idiopathic hypertrophic subaortic stenosis (IHSS) in older adults presents with varied symptoms, including angina and dyspnea, and can coexist with other cardiac conditions. Some patients remain asymptomatic, highlighting the nonspecific nature of IHSS presentation.
Area of Science:
- Cardiology
- Internal Medicine
- Geriatrics
Background:
- Idiopathic hypertrophic subaortic stenosis (IHSS) is a significant cardiovascular condition.
- Understanding IHSS in elderly patients (65-80 years) is crucial due to potential atypical presentations.
Purpose of the Study:
- To describe the clinical characteristics and diagnostic findings of IHSS in an elderly cohort.
- To identify common symptoms, diagnostic methods, and coexisting conditions in patients with IHSS.
Main Methods:
- Retrospective observation of 27 patients aged 65-80 diagnosed with IHSS over 24 months.
- Diagnosis confirmed via echocardiography and/or cardiac catheterization.
- Clinical data including symptoms, physical examination, and electrocardiography (ECG) were analyzed.
Main Results:
- Common symptoms included angina (17 patients), dyspnea (13), and syncope (11).
- Two patients were asymptomatic; one had ECG evidence of left ventricular hypertrophy (LVH) without murmurs.
- Coexisting conditions such as alpha streptococcal endocarditis (2 patients) and aortic valve disease (3 patients) were noted. ECG criteria for LVH were present in 14 patients.
Conclusions:
- IHSS symptoms in the elderly can be nonspecific, ranging from exertional chest discomfort to being entirely asymptomatic.
- Asymptomatic patients may exhibit ECG findings of LVH without typical murmurs.
- IHSS can coexist with valvular disease, coronary artery disease, and bacterial endocarditis, necessitating comprehensive patient evaluation.