Valvular heart disease, Part 1. Diagnosis and surgical management of aortic valve disease in older adults.

Aortic valve disease is a common cause of morbidity and mortality in older patients. The etiology, physical findings, and natural history of aortic stenosis and aortic regurgitation may differ in older patients compared with younger patients. In addition, symptoms of aortic valve disease may be masked or exacerbated by co-existent coronary artery disease, hypertension, pulmonary diseases, and other systemic disorders that commonly occur in the geriatric population. Clinical assessment, along with various non-invasive cardiac techniques including ECG, chest x-ray, and echocardiogram are important in identifying aortic valve disease as the cause of abnormal signs and symptoms in these patients. Recognition of aortic valve abnormalities has important therapeutic implications because aortic valve replacement is usually associated with favorable short- and long-term results, even in patients over age 65.