The old-age heart: normal aging changes which can produce or mimic cardiac disease.

The elderly segment of our society may triple by the year 2050. Specific cardiovascular data on the normal aging heart will be needed to provide proper medical and surgical therapy for this patient group. This report reviews normal aging changes of the very elderly heart. Expected or normal aging changes include brown atrophy of the myocardium, increased subepicardial fat, focal amyloid deposits, sigmoid-shaped ventricular septum, and calcific deposits in the aortic valve, mitral annulus and epicardial coronary arteries. Certain normal aging changes may produce clinical heart disease: aortic valve calcium (aortic stenosis), mitral valve annular calcium (mitral stenosis), amyloid deposits (amyloid heart disease). Certain normal aging changes may mimic heart disease: sigmoid-shaped ventricular septum (hypertrophic cardiomyopathy), mitral leaflet "buckling" (floppy mitral valve).