The relative incidence of rheumatic valve disease in New York and Costa Rica and its bearing on the rheumatic origin of calcareous aortic stenosis

Abstract

The incidence of rheumatic endocarditis of the mitral valve alone, and of the mitral and aortic valves together, in three independent series of autopsies is compared. Differences in the total incidence of valvular lesions were noted in each of the three series. These differences cannot be attributed to racial or geographical factors alone, since two of the series represent cases from essentially the same types of population in the New York area. However, the relative incidence of each type of valve lesion is constant in the three series. Mitral stenosis is more common in women than in men in each series. The incidence of calcareous deforming lesions, limited to the aortic valve, is also determined in the three autopsy series and is found to vary constantly with the incidence of rheumatic lesions in each of the three series. In males, lesions of the mitral valve alone, together with lesions of both mitral and aortic valves, are about two and one-half to three times as common in each series as are calcareous deforming lesions limited to the aortic valve. Lesions of the aortic valve only are more common in males and involve an older age group than do the other types of rheumatic lesions. The incidence of lesions of the aortic valve only, in the groups surviving longer than 50 years in each series, is relatively the same as for the entire age group in each series, however.