Pathology of the heart in the tenth decade

The pathology of the heart was studied in 60 patients dying in their tenth decade in a general hospital. The severity of coronary atherosclerosis and the incidence of ischaemic heart disease was lower than in younger geriatric patients. The incidence of minor ;aging' changes was similar to that in younger patients with the exception of mitral valve atheroma where the increase with aging continued into the tenth decade. Marked nodular thickening of the tricuspid valve was seen only in males. Over half the systolic murmurs heard were associated with mitral valve abnormalities and not with aortic valve changes. Multiple cardiac pathology was more frequent than in younger patients but its association with failure was much less striking. It is concluded that resistance to the development of coronary atherosclerosis and to failure being precipitated by the multiple minor cardiac abnormalities associated with aging are important factors in attaining extreme longevity.