Idiopathic Scoliosis in Old Age

Abstract Cardiovascular function has been studied in 15 female patients, 56 to 63 years of age, who were diagnosed as idiopathic scoliotics about 50 years ago. Eight of the patients had a severe skeletal deformity with a spinal angle of ≥60° (SD group); the remaining seven patients were less deformed (LD group). The examinations comprised ECGs at rest and during exercise, determination of work capacity, total amount of hemoglobin, blood volume and heart volume. Through heart catheterization in 13 subjects intracardiac and intravascular pressures and cardiac output were measured at rest and during work. Pulmonary hypertension with a restricted working capacity was found in the most severely deformed patient; all others had ordinary pressures and cardiac output both at rest and during work when compared with a healthy male material of the same age. On the ECG none of the patients developed signs of right ventricular impairment. A few patients had ST changes in the left precordial leads during work but were free from symptoms. The ECG findings were not related to the degree of the scoliosis, the working capacity or the heart volume. The SD group had a significantly lower working capacity than the LD group. When related to previously obtained respiratory data the working capacity was significantly correlated to tidal volume and to vital and total lung capacities. In one third of the patients with a low working capacity small circulatory dimensions were a characteristic feature. It could be assumed that a restricted lung function would decrease the physical activity and hence the circulatory dimensions to an extent related to the degree of deformity.