Purpose: The distinction between physiologic (innocent) and pathologic (organic) heart murmurs is not always easy in routine practice, leading too often to unnecessary cardiology referrals and expensive investigations. We aimed to test the hypothesis that the complete disappearance of murmur on standing can exclude cardiac disease in children.
Methods: From January 2014 to January 2015, we prospectively included 194 consecutive children aged 2 to 18 years who were referred for heart murmur evaluation to pediatric cardiologists at 2 French medical centers. Heart murmur characteristics while supine and then while standing were recorded, and an echo-cardiogram was performed.
Results: Overall, 30 (15%) of the 194 children had a pathologic heart murmur as determined by an abnormal echocardiogram. Among the 100 children (51%) who had a murmur that was present while they were supine but completely disappeared when they stood up, only 2 had a pathologic murmur, and just 1 of them needed further evaluation. Complete disappearance of the heart murmur on standing therefore excluded a pathologic murmur with a high positive predictive value of 98% and specificity of 93%, albeit with a lower sensitivity of 60%.
Conclusions: Disappearance of a heart murmur on standing is a reliable clinical tool for ruling out pathologic heart murmurs in children aged 2 years and older. This basic clinical assessment would avoid many unnecessary referrals to cardiologists.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683863 | PMC |
| http://dx.doi.org/10.1370/afm.2105 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Echocardiographic Changes in Dogs with Stage B2 Myxomatous Mitral Valve Disease Treated with Pimobendan Monotherapy.
Vet Sci
November 2024
Department of Small Animal Clinical Science, School of Veterinary Science, University of Liverpool, Cardiology Service, Small Animal Teaching Hospital, Chester High Road, Neston CH64 7TE, UK.
The present study aimed to evaluate the effects of chronic pimobendan monotherapy on cardiac size in dogs with stage B2 myxomatous mitral valve disease (MMVD). Data from 31 dogs diagnosed with MMVD and cardiomegaly (LA/Ao ≥ 1.6 and LVIDdn ≥ 1.
View Article and Find Full Text PDFNew wearable cardiac acoustic monitoring technology for evaluation of subclinical leaflet thrombosis after transcatheter aortic valve replacement.
Heart
December 2024
Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
Background: Subclinical leaflet thrombosis (SLT) is a common complication after transcatheter aortic valve replacement (TAVR). Multidimensional CT (MDCT) is the main imaging mortality for the diagnosis of SLT but it enhances the risk of contrast-induced nephropathy. Our study aimed to use an innovative wearable acoustic cardiography (ACG) device to diagnose SLT as an alternative option.
View Article and Find Full Text PDFAcute thrombosis of ductus arteriosus aneurysm causing bilateral pulmonary artery occlusion in a neonate.
J Cardiothorac Surg
December 2024
Department of congenital heart surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
A 9-day-old male neonate was found to have a systolic murmur during a routine follow-up for skin jaundice. Imaging revealed a large mass at the bifurcation of the main pulmonary artery, causing significant bilateral stenosis. The patient underwent emergency surgery due to critically compromised pulmonary blood flow.
View Article and Find Full Text PDF[An unusual tricuspid regurgitation].
G Ital Cardiol (Rome)
January 2025
U.O. Cardiologia, Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi, Brescia.
Tricuspid regurgitation can be due to different causes and mechanisms. Among these, cardiac involvement in carcinoid disease is a rare cause of tricuspid valve disease with a peculiar echocardiographic aspect. We report the case of a 59-year-old woman, with no past medical history, who was recently found to have a heart murmur and signs of right heart failure.
View Article and Find Full Text PDFCardiac myxoma with high standardized uptake value of FDG-PET-CT in the right ventricular outflow tract.
Gen Thorac Cardiovasc Surg Cases
December 2024
Department of Cardiovascular Surgery, Teikyo University Hospital, 2-21-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan.
Background: Cardiac myxoma rarely occurs in the right ventricle, and as is a benign disease, it rarely shows high positivity on 18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT).
Case Presentation: We present herein the case of a 77-year-old woman who was found to have a heart murmur during a routine health checkup. Further examination revealed a 27-mm tumor in the right ventricular outflow tract (RVOT) and moderate aortic valve stenosis.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!