Chronic non-rheumatic aortic valvular disease: A population study based on autopsies

Abstract

In Iceland the autopsy rate is high and relatively unselected and therefore well suited for population studies of chronic diseases. Chronic non-rheumatic aortic valvular diseases were studied at autopsy during a period of 9 yr. The series included 29.6% of those who died in Iceland at the age of 15 yr and older. Calcific aortic stenosis was found in 130 hearts, or in 3.43% of males and in 3.82% of females, and uncalcified bicuspid aortic valves in 19 hearts, or in 0.72% of males and in 0.21% of females. Most subjects with calcific aortic stenosis also had coronary heart disease and among them myocardial infarcts were found in 44.7%, of males and in 25.9% of females. Among those with calcific aortic stenosis, the valvular disease was considered significant as contributory to the death of 40.8% of males and in 33.3% of females and its importance had been underestimated by both pathologists and clinicians. Aortic valvular disease is more frequently found at autopsy than reported in hospital and mortality statistics. The Icelandic results may apply in many other countries of the Western world, where it would be almost impossible to perform a comparable autopsy study.