Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Systolic Murmurs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1989

[Is this mitral valve prolapse? A case of mitral regurgitation with early systolic murmur due to early systolic prolapse of the posterior leaflet].

This paper reports the findings of phonocardiograms, echocardiogram and Doppler echocardiograms in a case of a 50-year-old man with early mitral valve prolapse with an early systolic murmur. A characteristic early systolic crescendo murmur was recorded at the apex. By amyl nitrite inhalation, the early systolic murmur was attenuated and a late systolic murmur was evoked. On the contrary, methoxamine injection increased the intensity of the early systolic murmur. Early systolic prolapse and early systolic buckling were recorded by two-dimensional and M-mode echocardiography. The phase of mitral regurgitation detected by M-mode color Dopper echocardiography coincided well in timing with the early systolic murmur and the early systolic buckling recorded on the M-mode echocardiogram. A discussion was made on the mechanism of the early systolic mitral regurgitation due to early mitral valve prolapse.

Amyl Nitrite↗
PubMed1949

Difficulties in evaluating systolic murmurs in children; with special reference to the functional systolic murmur.

As a guide in distinguishing between organic and functional systolic murmurs, five characteristics of a murmur should always be noted, namely, (a) the location of maximal intensity of the murmur; (b) the intensity of the murmur itself; (c) the character of the murmur, that is, whether it is blowing, rumbling, rough or harsh; (d) the transmission of the murmur; and (e) the duration of the murmur and its time within the cardiac cycle. Functional systolic murmurs may be found at any of the "valve areas," are usually faint to moderately loud, are usually soft and blowing in quality, are usually only slightly transmitted, and are usually not heard immediately following the first heart sound. In doubtful cases, those in which history and physical examination alone are not sufficient to make a diagnosis of functional systolic murmur, further studies should be undertaken to determine the presence or absence of organic heart disease. Until a diagnosis of organic heart disease can be made with reasonable certainty, there should be no restriction of activity imposed, because of the likelihood of the development of cardiac neurosis in the patient.

Child↗
PubMed1987

[Musical systolic murmur produced by oscillation of the systolic anterior motion of the mitral apparatus: relation to the genesis of Still's murmur].

The genesis of a musical systolic murmur produced by systolic anterior motion (SAM) of the mitral apparatus was investigated in four patients using phonocardiography and echocardiography. Two patients (Case 1 and 3) had hypertrophic cardiomyopathy (one, the obstructive type; the other, the nonobstructive type) and the remaining two (Case 2 and 4) had redundant chordae tendineae. 1. In every patient, regular oscillation of the SAM was observed, coinciding in time with the musical systolic murmur, which was simultaneously recorded. The fundamental frequency of the musical systolic murmur was recorded as integrally multiplied numbers of the SAM. Such regular oscillation was not observed in the echograms of other cardiac structures. In a patient with hypertrophic obstructive cardiomyopathy (Case 1), both the amplitude and oscillation of the SAM were increased by amyl nitrite inhalation, and were decreased by angiotensin II infusion. Correspondingly, the intensity of the musical murmur showed similar reaction. No findings suggestive of mitral valve prolapse or mitral regurgitation were found in any patients. Therefore, the oscillation of the SAM produced by blood ejected from the left ventricle was considered the source of the musical systolic murmur in these patients. 2. Two patients with redundant chordae tendineae had no clinical abnormalities except for chordal redundancy; therefore, the musical murmur in these cases was considered to be functional. Particularly, one of them was compatible in character with the so-called Still's murmur. In conclusion, the regular oscillation of the SAM may be the source of the musical systolic murmur, and they must be taken into consideration as part of the genesis of Still's murmur.

Adolescent↗
PubMed2000

Echocardiography in the evaluation of systolic murmurs of unknown cause.

PURPOSE: Systolic murmurs are common, and it is important to know whether physical examination can reliably determine their cause. Therefore, we prospectively assessed the diagnostic accuracy of a cardiac examination in patients without previous echocardiography who were referred for evaluation of a systolic murmur. SUBJECTS AND METHODS: In 100 consecutive adults (mean [+/- SD] age of 58 +/- 22 years) who were referred for a systolic murmur of unknown cause, the diagnostic accuracy of the cardiac examination by cardiologists (without provision of clinical history, electrocardiogram, or chest radiograph) was compared with the results of echocardiography. RESULTS: The echocardiographic findings included a normal examination (functional murmur) in 21 patients, aortic stenosis in 29 patients, mitral regurgitation in 30 patients, left or right intraventricular pressure gradient in 11 patients, mitral valve prolapse in 11 patients, ventricular septal defect in 4 patients, hypertrophic obstructive cardiomyopathy in 3 patients, and associated aortic regurgitation in 28 patients. In 28 (35%) of the 79 patients with organic heart disease, more than one abnormality was found; combined aortic and mitral valve disease was the most frequent combination (n = 22). The sensitivity of the cardiac examination was acceptable for detecting ventricular septal defect (100% [4 of 4]), isolated mitral regurgitation (88% [26 of 36]), aortic stenosis (71% [21 of 29]), and a functional murmur (67% [14 of 21]), but not for intraventricular pressure gradients (18% [2 of 11]), aortic regurgitation (21% [6 of 28]), combined aortic and mitral valve disease (55% [6 of 11]), and mitral valve prolapse (55% [12 of 22]). In 6 patients, the degree of aortic stenosis was misjudged on the clinical examination, mainly because of a severely diminished left ventricular ejection fraction. Significant heart disease was missed completely in only 2 patients. CONCLUSION: In adults with a systolic murmur of unknown cause, a functional murmur can usually be distinguished from an organic murmur. However, the ability of the cardiac examination to assess the exact cause of the murmur is limited, especially if more than one lesion is present. Thus, echocardiography should be performed in patients with systolic murmurs of unknown cause who are suspected of having significant heart disease.

Adolescent↗
PubMed1992

[Doppler and echocardiographic study of normal systolic murmurs].

To elucidate the genesis of normal ejection systolic murmurs, we performed phono and Doppler echocardiography in 42 normal subjects. Individuals with hypertension, ST.T changes on ECG, anemia or other cases with definite cardiovascular findings were excluded from the study. Their ages ranged from 22 to 61 years with an average of 48.1 years. They were classified in 2 groups; 9 with Levine 2/6 systolic murmur and 33 without murmur or with 1/6 murmur. Fifteen patients with pure aortic regurgitation or with aortic prosthesis but without significant stenosis, and 7 patients with pulmonic valvular stenosis were served as control. We correlated the intensity and timing of murmur with maximal flow velocity, acceleration time and other parameters. All systolic murmurs were early systolic. Mid-systolic murmur was not noted. Peak of flow velocity increased at the aortic orifice than at the left ventricular outflow tract or pulmonary orifice. Left-sided peak flow velocity occurred earlier than the right-sided peak flow velocity. Early systolic maximal flow velocity of the aorta significantly increased in 9 subjects with murmur than in the remaining 33 without significant murmur. Ejection fraction, hematocrit and body surface area did not differ between the groups with and without significant murmur. Systolic blood pressure and age, however, were higher in subjects with murmur. In aortic valvular disease, systolic murmurs and peak flow signals were early systolic, but in pulmonary stenosis these were mid-systolic in timing. In conclusion, normal ejection systolic murmurs were early systolic and originated at the aortic orifice. Mid-systolic murmurs were unlikely as left-sided murmur in origin. Flow velocity was the most important determinant of the intensity of ejection murmur.

Adult↗
PubMed2003

Transesophageal echocardiographic evaluation of perioperative systolic murmur in aortic pathology.

Development of a new systolic murmur in patients following a Bental procedure with a prosthetic or homograft aortic valve usually indicates an aortic valve-related complication. Here, we report new etiologies of a loud systolic murmur in patients with aortic disease. One patient developed a new loud systolic murmur as an initial manifestation of acute type A aortic dissection without any complication, and two patients developed a loud systolic murmur as the major manifestation of aortic graft failure following aortic root surgery. Auscultation of a new loud systolic murmur in the upper chest in patients with known aortic disease should alert one to a complication within the ascending aorta.

Adult↗
PubMedDate not supplied

Do systolic murmurs predict mortality in the elderly? A 15-year longitudinal population study of 70-year-olds.

Systolic murmurs are common in the elderly but there is a striking paucity regarding published reports on their clinical significance and relation with mortality. This study describes prevalence of systolic murmurs in the elderly and cardiovascular diseases in 70-year-olds with or without systolic murmurs, and investigates the relation between systolic murmurs at age 70 and 15-year mortality. This cohort study is based on 973 (449 males and 524 females) 70-year-olds from Göteborg, Sweden who were examined in 1971/1972 at the Department of Geriatric Medicine, Göteborg University, and was followed-up to the year 2001. The prevalence of systolic murmur was 31% (females 36.4%, males 23.9%). Among subjects with systolic murmurs the prevalence of coronary heart disease (CHD) and hypertension was significantly higher in both sexes and congestive heart failure (CHF) in females only. Systolic murmur was a predictor for mortality in females (RR 1.49, 95% CI 1.17-1.91) but not in males (RR 1.14, 95% CI 0.89-1.49). Diagnosis of a cardiovascular disease was a significant predictor in both sexes for mortality irrespective of having systolic murmurs. In conclusion, there is a significant positive association of cardiovascular diseases with systolic murmurs in the elderly. The increased risk for mortality due to the presence of systolic murmur at age 70 is mediated through cardiovascular diseases.

Aged↗
PubMed1987

Risk of infective endocarditis in mitral valve prolapse with and without precordial systolic murmurs.

The risk of infective endocarditis (IE) associated with a systolic murmur in patients with mitral valve prolapse (MVP) was investigated in a case-control study. The case group comprised all patients with MVP (n = 19) from a series of 136 consecutive adult admissions for IE. Three matched control subjects were chosen for each case from a series of 144 MVP patients without IE. Seventeen of the 19 cases (89%) had documented evidence of systolic murmurs existing before the IE episode; systolic murmurs were documented in 25 of the 57 control subjects (47%). The data indicate a significant increase in the risk of IE in MVP patients with a systolic murmur (p less than 0.01). The absolute probability of IE developing in a patient with MVP and a murmur was estimated to be approximately 1 in 1,400 per year; this was 35 times greater than the probability in a patient with MVP without a murmur. The results suggest that by restricting prophylaxis to MVP patients with a systolic murmur, cover would be provided for almost 90% of those with MVP in whom IE would be likely to develop.

Adolescent↗
PubMed2003

Echocardiography or auscultation? How to evaluate systolic murmurs.

OBJECTIVE: To compare cardiac physical examination with echocardiography for evaluating systolic murmurs. QUALITY OF EVIDENCE: Three databases were searched for studies comparing echocardiography and auscultation as to sensitivity and diagnostic accuracy: MEDLINE (Ovid Online), EMBASE, and Current Contexts. The quality of reported data is lowered by subjective interpretation of results of both cardiac physical examination and echocardiography, especially Doppler colour flow imaging. MAIN MESSAGE: In adults, functional systolic murmurs can usually be distinguished from organic murmurs. Pathologic murmurs frequently have one or more associated clinical abnormalities. If a clinician determines a murmur is benign, results of echocardiography are very likely to be normal, especially in young and middle-aged adults. According to current guidelines, echocardiography should not be ordered for "innocent" systolic murmurs in patients who are asymptomatic and have otherwise normal findings on examination. If patients with functional systolic murmurs could be identified and not routinely referred for echocardiography, great cost savings could be realized. CONCLUSION: Echocardiography is not required for all patients with systolic murmurs and should not replace cardiac physical examination.

Adult↗
PubMed1977

Systolic time intervals in the syndrome of midsystolic click and late systolic murmur.

Left ventricular function, as measured by systolic time intervals, was studied in 30 subjects with the syndrome of midsystolic click and late systolic murmur (ages, 20 to 53 years; mean, 34 +/- 9 years). Twenty-one were asymptomatic, six had chest pain, two had palpitations, one had shortness of breath, and one had hypotensive episodes. Each patient had the typical auscultatory and echocardiographic findings of the syndrome of midsystolic click and late systolic murmur. In the study the values for the interval between the onset of the QRS complex (Q) and the aortic component of the second heart sound (A2) (377 +/- 42 msec), the Q-A2 index (532 +/- 39 msec), the preejection period (PEP) (97 +/- 17 MSEC), THE PEP index (127 +/- 16 msec), the left ventricular ejection time index (403 +/- 26 msec) and the ratio of PEP to left ventricular ejection time (0.35 +/- 0.01) were not significantly different from the values in 17 controls matched for age. Out study, then, supports the contention that left ventricular function remains well preserved in most patients with the syndrome of midsystolic click and late systolic murmur.

Adult↗
PubMed1993

Nonspecific systolic murmurs: an audit of the clinical value of echocardiography.

AIM: To evaluate the clinical use of echocardiography in patients with nonspecific systolic murmurs. METHODS: Analysis of request forms and echocardiogram reports in a consecutive series of scans done for patients with nonspecific systolic murmurs between 1984 and 1991. RESULTS: Normal cardiac structure and function were found in: (1) 62% of 565 studies done for patients with nonspecific systolic murmurs; (2) 96% of 69 scans in patients with clinical diagnosis of a benign murmur and (3) 93% of 45 pregnant women with nonspecific systolic murmurs. No echocardiographic abnormalities were detected in 76% of studies done for patients aged between 1 and 50 yr. Congenital heart disease was found in 39% of patients with nonspecific systolic murmurs aged between 0 and 1 yr. Mitral regurgitation was found in 33% and aortic valve disease in 22% of nonspecific systolic murmurs patients aged over 60 yr. CONCLUSIONS: Echocardiography rarely revealed significant abnormalities in the assessment of patients with nonspecific systolic murmurs aged between 1 and 50 yr, especially when the test was used to confirm the clinical suspicion that the heart was normal. Ultrasound scanning was useful in the assessment of nonspecific murmurs in patients aged 0-1 yr or over 50 yr, particularly those over 60 yr.

Adolescent↗
PubMed2004

Initial clinical evaluation of cardiac systolic murmurs in the ED by noncardiologists.

It is not exactly known how ED physicians perform in evaluating cardiac systolic murmurs. In 203 consecutive medical ED patients with systolic murmur, we compared the initial clinical evaluation, including auscultation, with transthoracic echocardiography. Of the 203 patients, 132 (65%) had innocent murmurs and 71 patients (35%) had valvular heart disease. Sensitivity and specificity of the initial clinical routine evaluation in diagnosing echocardiographic valvular heart disease were 82% (70%-86%) and 69% (60%-76%), respectively. Independent significant positive predictors of valvular heart disease were grade >2/6 systolic murmur (odds ratio [OR], 8.3; confidence interval [CI], 3.5-19.7, P<.001) and pathologic electrocardiogram (ECG) (OR, 8.4; CI, 3.2-22, P<.001. Patients younger than 50 years with a systolic murmur graded < or =2/6 had innocent murmurs in 98%. The initial clinical evaluation, including auscultation, by experienced ED physicians in internal medicine distinguishes well between innocent murmurs and valvular heart disease in medical patients with cardiac systolic murmurs.

Adolescent↗