Chapter12 -Effects of Aging on the Heart

Question 1

Effects of Aging on the Heart

TABLE 12-1 – Changes in the Aging Heart

CHAMBERS

Answer 1

• Increased left atrial cavity size
• Decreased left ventricular cavity size
• Sigmoid-shaped ventricular septum

Question 2

Effects of Aging on the Heart

TABLE 12-1 – Changes in the Aging Heart

VALVES

Answer 2

• Aortic valve calcific deposits
• Mitral valve annular calcific deposits
• Fibrous thickening of leaflets
• Buckling of mitral leaflets toward the left atrium
• Lambl excrescences

Question 3

Effects of Aging on the Heart

TABLE 12-1 – Changes in the Aging Heart

EPICARDIAL CORONARY ARTERIES

Answer 3

• Tortuosity
• Increased cross-sectional luminal area
• Calcific deposits
• Atherosclerotic plaque

Question 4

TABLE 12-1 – Changes in the Aging Heart

MYOCARDIUM

Answer 4

• Increased mass
• Increased subepicardial fat
• Brown atrophy
• Lipofuscin deposition
• Basophilic degeneration
• Amyloid deposits

Question 5

TABLE 12-1 – Changes in the Aging Heart

AORTA

Answer 5

• Dilated ascending aorta with rightward shift
• Elongated (tortuous) thoracic aorta
• Sinotubular junction calcific deposits
• Elastic fragmentation and collagen accumulation
• Atherosclerotic plaque

Question 6

With advancing age, the amount of epicardial fat increases, particularly over the _____________

Answer 6

anterior
surface of the right ventricle and in the atrial septum.

Question 7

What is sigmoid septum?

Answer 7

A reduction in the size of the left
ventricular cavity, particularly in the base-to-apex dimension, occurs with aging and may be
exacerbated by systemic hypertension and sometimes by bulging of the basal ventricular
septum into the left ventricular outflow tract (termed sigmoid septum).

These changes in the left
ventricular cavity can produce a functional outflow obstruction similar to that seen in
hypertrophic cardiomyopathy, discussed later in this chapter.

Question 8

Valvular aging changes include calcification of the __________

Answer 8

mitral annulus and aortic valve

the latter
frequently leading to aortic stenosis.

,

Question 9

In addition, the valves can develop fibrous thickening, and the mitral leaflets tend to buckle back toward the left atrium during ventricular systole,
simulating a prolapsing (myxomatous) mitral valve.

Question 10

What is Lambl excrescences?

Answer 10

Moreover, many older persons develop small
filiform processes (Lambl excrescences) on the closure lines of aortic and mitral valves, probably resulting from the organization of small thrombi

Question 11

What is the difference between a younger myocardium compared to the elderly?

Answer 11

Compared with younger myocardium, “elderly” myocardium has fewer myocytes, increased
collagenized connective tissueand, in some individuals, deposition of amyloid.

Lipofuscin
deposits ( Chapter 1 ) and basophilic degeneration, an accumulation within cardiac myocytes of a gray-blue by-product of glycogen metabolism, may also be present.

Question 12

What brown atrophy?

Answer 12

Extensive lipofuscin
deposition in a small, atrophied heart is called brown atrophy; this change often accompanies
cachexia, as seen in terminal cancer.