Valvular heart disease in the elderly.

Patients with isolated or combined valvular heart disease who reach old age without symptoms or functional impairment can usually be managed with medical therapy. Prevention of infective endocarditis is important. When symptoms impair activities of daily living, surgery should be considered. Aortic stenosis is the most important valvular lesion in the aged and its severity is often underestimated; valve replacement markedly improves the prognosis for symptomatic patients with significant valvular obstruction.