Cardiac valve disorders: growing significance in the elderly.

Accompanying the aging of the population has been a change in the presentation and the manifestations of valvular heart disease. Calcific aortic stenosis is now the most frequent reason for valvular heart surgery and differs greatly from the stenosis produced by rheumatic fever or a congenital bicuspid valve. Mitral insufficiency is found with increasing frequency and is often due to a calcified mitral valve annulus. Mitral valve prolapse, once thought to be a disease found in younger patients, is being diagnosed more and more in the elderly and is a significant cause of mitral regurgitation. It is important for the physician caring for the older patient to be aware of the differing presentations, manifestations, and implications of valvular diseases in the elderly.