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Detection of Aortic Insufficiency by Standard Echocardiography, Pulsed Doppler Echocardiography, and Auscultation: A Comparison of Accuracies

PAUL A. GRAYBURN, M.D.; MIKEL D. SMITH, M.D.; RODNEY HANDSHOE, M.D.; BRUCE J. FRIEDMAN, M.D.; and ANTHONY N. DeMARIA, M.D.
[+] Article and Author Information

Grant support: in part by an American Heart Association Kentucky Affiliate Fellowship Grant.

Presented in part 13 November 1985 at the 58th scientific session of the American Heart Association, Washington, D.C.

▸Requests for reprints should be addressed to Paul A. Grayburn, M.D.; Division of Cardiology, Department of Medicine, University of Kentucky College of Medicine, 800 Rose Street, MN-670; Lexington, KY 40536-0084.


Lexington, Kentucky


© 1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;104(5):599-605. doi:10.7326/0003-4819-104-5-599
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To determine the relative sensitivity and specificity of noninvasive methods for detecting aortic insufficiency, we compared the accuracy of auscultation, echocardiography, and pulsed Doppler echocardiography in detecting aortic insufficiency in 106 patients in whom the presence or absence of the lesion was shown by supravalvular aortography. The sensitivity and specificity for the diagnosis of aortic regurgitation was 96% and 96% for pulsed Doppler echocardiography, 73% and 92% for auscultation, 43% and 91% for two-dimensional echocardiography, 46% and 81% for anterior mitral leaflet flutter, and 9% and 96% for ventricular septal flutter, respectively. Auscultation was more sensitive than either M-mode or two-dimensional echocardiography in the diagnosis of aortic insufficiency (p < 0.01). Pulsed Doppler echocardiography was significantly more sensitive than auscultation (p < 0.0001) and was positive in 19 patients in whom no murmur was found. Thus, pulsed Doppler echocardiography is the optimal noninvasive marker for aortic insufficiency.

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