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Prevalence of Regurgitant Murmurs in Patients with Valvular Regurgitation Detected by Doppler Echocardiography

Peter S. Rahko, MD
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Requests for Reprints: Peter S. Rahko, MD, Cardiology Section, H6/ 334 CSC, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792.

Current Author Address: Dr. Rahko: Cardiology Section, H6/334 CSC, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792.

© 1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(6):466-472. doi:10.7326/0003-4819-111-6-466
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Study Objective: To determine the relation between heart valve regurgitation detected by Doppler echocardiography and audible regurgitant murmurs.

Design: Consecutive sample.

Setting: Adult echocardiography laboratory in a tertiary care university hospital.

Patients: Sequential sample of 408 patients presenting for clinical echocardiographic studies who had technically satisfactory studies and were available for auscultation.

Measurement and Main Results: Valvular regurgitation occurred in 43% of patients at the mitral valve, 39% of patients at the tricuspid valve, 33% of patients at the aortic valve, and 15% of patients at the pulmonic valve. Corresponding regurgitant murmurs were frequently absent. A murmur corresponding to Doppler-detected regurgitation was detected in 56% of patients with mitral regurgitation, 61% of patients with aortic regurgitation, 28% of patients with tricuspid regurgitation, and 15% of patients with pulmonic regurgitation. There was a highly significant positive correlation of audibility with severity of valve regurgitation for the aortic, tricuspid, and mitral valves. Audibility ranged from 10% to 40% for mild regurgitation to 86% to 100% for severe regurgitation. Murmur audibility was not related to the type of valvular disease present.

Conclusions: Doppler echocardiography is a sensitive method for detecting valve regurgitation. Corresponding regurgitant murmurs are frequently not present. The audibility of regurgitant murmur is highly dependent on the severity of valve regurgitation and has little relation to the type of valve disease present.





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