Changes in the ageing heart

CHAMBERS :

  1. Increased left atrial cavity size (2-4 cm generally)
  2. Decreased left ventricular cavity size (42-59 mm in men and 39-53 in women normally)
  3. Sigmoid shaped ventricular septum

VEINS :

  1. Aortic valve calcific deposits
  2. Mitral valve annular calcific deposits
  3. Fibrous thickening of leaflets
  4. Buckling of mitral leaflets towards the left atrium
  5. Lambl excrescenses (filiform fronds that occur at sites of valvular closure. They originate as small thrombi on endoardial suraces where the valve margins make contact)

EPICARDIAL CORONARY ARTERIES :

  1. Tortuosity

2. Increased cross sectional luminal area

3. Calcific deposits

4. Atherosclerotic plaque

MYOCARDIUM :

  1. Increased mass
  2. Increased subepicardial fat
  3. Brown atrophy (atrophy of the heart muscle described as brown as fibers become pigmented by intracellular deposits of lipofuscin, a type of lipochrome granule)
  4. Basophilic degeneration (an accumulation within cardiac myocytes of a gray-blue byproduct of glycogen metabolism)
  5. Amyloid deposits

AORTA :

  1. Dilated ascending aorta with rightward shift
  2. Atherosclerotic plaque
  3. Elastic fragmentation and collagen accumulation
  4. Elongated (tortuous) thoracic aorta

Source : Robbins and Cotran’s book of pathology

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