Movahed Mohammad-Reza, Ebrahimi Ramin
Department of Medicine, Sarver Heart Center, University of Arizona Medical Center, Tucson, Arizona 85724, USA.
Echocardiography. 2007 May;24(5):447-51. doi: 10.1111/j.1540-8175.2007.00425.x.
The prevalence of valvular abnormality and innocent murmur in patients who are referred for echocardiographic evaluation with the diagnosis of "murmur" is not known. The goal of this study was to evaluate the prevalence of valvular abnormalities in such patients.
We retrospectively reviewed the echocardiograms that were referred with the primary ordering diagnosis of "murmur," for the presence of valvular abnormalities. For comparison, we used other documented primary reasons for echocardiographic referral, such as chest pain, shortness of breath, etc.
In this cohort, 7,684 echocardiogram reports documented primary diagnostic reasons for echocardiographic referral. A total of 3,460 echocardiogram reports (45%) were coded "murmur" as the primary reason for the study referral. There was a higher prevalence of female patient referrals for heart murmur evaluation (61.8% vs. 38.2%). Although, patients with murmur had a higher prevalence of valvular abnormalities, compared to other reasons for echocardiographic examination, the prevalence of valvular abnormality was less than 50% (48.6% vs. 35.5%) in both groups. Despite the higher number of female patients referred with the diagnosis of murmur, the percentage of abnormal valves was lower in women (45.6% vs. 53.4% in men).
The prevalence of valvular abnormalities in patients who were referred with the diagnosis of murmur for echocardiographic examination was less than 50%, with a lesser degree found in women. Routine utilization of echocardiography for evaluation of all murmurs may be unwarranted.
对于因“杂音”诊断而接受超声心动图评估的患者,瓣膜异常和无害性杂音的患病率尚不清楚。本研究的目的是评估此类患者中瓣膜异常的患病率。
我们回顾性分析了以“杂音”作为主要诊断医嘱而转诊的超声心动图检查结果,以确定是否存在瓣膜异常。为作比较,我们使用了超声心动图转诊的其他记录在案的主要原因,如胸痛、呼吸急促等。
在该队列中,7684份超声心动图报告记录了超声心动图转诊的主要诊断原因。共有3460份超声心动图报告(45%)将“杂音”列为研究转诊的主要原因。因心脏杂音评估而转诊的女性患者比例较高(61.8%对38.2%)。尽管与超声心动图检查的其他原因相比,有杂音的患者瓣膜异常的患病率更高,但两组中瓣膜异常的患病率均低于50%(48.6%对35.5%)。尽管因杂音诊断而转诊的女性患者数量较多,但女性瓣膜异常的比例较低(女性为45.6%,男性为53.4%)。
因杂音诊断而接受超声心动图检查的患者中,瓣膜异常的患病率低于50%,女性患者的患病率较低。对所有杂音均常规使用超声心动图进行评估可能没有必要。