Pericardial Lesions in the Elderly Patients An Autopsy Study

Pericardial lesions were demonstrated in 79 of 1, 000 consecutive autopsy cases of elderly patients over the age of 60 at Yokufukai Geriatric Hospital, Tokyo. The lesions observed were pericardial effusion of 100ml or more in 35, pericadial adhesion in 16, hemopericardium in 16, malignant pericarditis in 5, acute pericarditis in 4, subepicardial hematoma in 3, and chronic pericarditis in 2 cases. The pericardial effusion was frequently associated with pleural effusion or generalized edema, and considered mainly due to congestive heart failure and/or hypoalbuminemia. The pericardial adhesion was the result of pericarditis complicating myocardial infarction in 2 and tuberculous pericarditis in 3 cases. Definite etiology was not determined in the remaining 11 cases, but it is noted that pleural adhesion was also present in 9 of them. The malignant pericarditis was due to either extention or metastasis of the carcinoma of the lung, breast or colon. The acute pericarditis occurred as a complication of generalized or intrathoracic infection. The cause of hemopericardium was cardiac rupture following myocardial infarction in 11 and ruptured aortic aneurysm in 5 cases. Ten of these 11 cases of cardiac rupture were female: the incidence of cardiac rupture in myocardial infarction proved at autopsy was 1.5per cent in males and 12.5per cent in females.