Congenital Heart Disease in the Patients Aged 40 and Over

Abstract

Ninety-four patients with congenital heart disease, aged 40 and over, visited our department between Jan., 1973 and Dec., 1983. The ages of the patients ranged from 40 to 79 years. The frequent lesions were atrial septal defect (66 cases), ventricular septal defect (9 cases), patent ductus arteriosus (7 cases), endocardial cushion defect (4 cases), Ebstein's anomaly (3 cases), tetralogy of Fallot (3 cases), ruptured aneurysm of sinus of Valsalva (1 case) and cor triatriatum (1 case).
Only 14 of 94 patients were diagnosed as having congenital heart disease previously, while the presence of cardiac disease was first pointed out by us in 10 patients. The number of patients with marked limitation of physical activity, classfied as NYHA calss III or IV, increased with the advancing age: 31.3% in fifth decade, 45.5% in sixth decade and 100% in patients over the age of 60 years, respectively.
The courses of 64 cases followed for more than 2 years were generally good under appropriate medical or surgical care. Fifteen patients who underwent radical operation were all doing well. Only 3 died, while 7 patients worsened. Five of the latter 7 cases were not treated at any medical institution after their first visit to our hospital.