ABSTRACT
Purpose - To evaluate the different aspects of chronic atrialfibrillation (CAF) in elderly patients. Methods - Forty nine patients with CAF (18 men) aged 66 to 87 years (76,1 years on average) were studied. Their evaluation consisted of clinical examination, blood tests, electrocardiogram, chest X-Ray and echocardiogram. Results - The frequency of CAF in the outpatient Geriatric Clinic was 4.8% and it rose with aging. Cardiocirculatory diseases were observed in 39 (79.6%) patients: 25 (51.0%) had systemic arterial hypertension, 11 (22.4%) had mitral valve disease and six (11.2%) had aortic valve disease. Thirty patients had diseases of other systems, eight (16.3%) of whom were diabetic and seven (14.3%) had hyperthyroidism. Vascular brain disease was observed in four (8.2%) patients. Electrocardiographic changes other than CAF were observed in 41 (83.7%) patients. Changes in the ST-T segment were the morefrequent, being observed in 28 (57.1%) patients, followed by left ventricular hypertrophy in 15 (30.1%). Cardiomegaly was seen in 36 (78.3%) out of 46 patients who did the chest radiography. An echocardiogram was performed in 35 patients, being found normal in seven (20.0%). In the remaining cases, the abnormality morefrequently seen was the left atrial enlargment, seen in 16 (45.7%) patients. Four patients didn't show clinical, electrocardiographic, radiological or echocardiographic evidence of cardiocirculatory disease and in these, the thyroidfunction was normal. Digitalis therapy was used in 37 patients. Of the remaining 12,10 had normal ventricular frequency without the use of the drug...
Subject(s)
Endocrine System Diseases/complications , Cardiovascular Diseases/complications , Atrial Fibrillation/complications , Aged, 80 and over , Brazil/epidemiology , Echocardiography , Electrocardiography , Endocrine System Diseases/diagnosis , Endocrine System Diseases/epidemiology , Chronic Disease , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Atrial Fibrillation/diagnosis , Atrial Fibrillation/epidemiology , Medical RecordsABSTRACT
O estudo ecocardiográfico de 480 pacientes com idade igual ou superior a 60 anos, demonstrou que 37 eram portadores de calcificaçäo mitral (CM). Destes, 33 eram do sexo feminino e quatro do sexo masculino, com idade variável de 63 a 98 anos (média 75,4 anos). A análise dos dados clínicos, eletrocardiográficos, fonocardiográficos, ecocardiográficos e metabólicos permitiu evidenciar: 1) a CM foi obsrvada em 7,7% dos pacientes com mais de 60 anos, sendo que a incidência tende a aumentar com o progredir da idade; 2) a CM foi mais freqüente e acentuada nas mulheres; 3) afecçöes cardiocirculatórias, que elevam a pressäo sistólica ventricular esquerda, como a hipertensäo arterial (64,9%) e a estenose aórtica (10,8%) foram as mais observadas nesses pacientes; 4) näo se conseguiu evidenciar antecendentes de enfermidades que pudessem ter lesado previamente a valva mitral; 5) näo se observaram alteraçöes dos lípides e do cálcio séricos; 6) o progressivo depósito de cálcio, atingindo as lacíneas, determinou em 27,0% dos casos, insuficiência e/ou estenose mitral, passível até de correçäo cirúrgica; 7() foram freqüentes as alteraçöes no mecanismo de produçäo e/ou conduçäo do estímulo cardíaco, levando ao desenvolvimento de bradiarritmias, taquiarritmias e de bloqueios intraventriculares. A vista do acima exposto, recomenda-se que, após confirmaçäo diagnóstica, o apciente deverá ser acompanhado periódicamente para que as complicaçöes sejam detectadas e tratadas prececemente