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British Heart Journal Aug 1977An early diastolic murmur thought to indicate functional aortic regurgitation was heard in 7 of 74 consecutive patients with end-stage renal failure assessed for chronic...
An early diastolic murmur thought to indicate functional aortic regurgitation was heard in 7 of 74 consecutive patients with end-stage renal failure assessed for chronic intermittent haemodialysis and transplantation. In all 7 cases the murmur was transient and related to episodes of hypertension and fluid overload and disappeared on correction of these factors. In a further 2 patients aortic regurgitation resulted from a structural abnormality of the aortic valve. Thus, an early diastolic murmur is not uncommon in this situation and does not necessarily indicate organic aortic valve disease which might preclude selection for haemodialysis and transplantation.
Topics: Adolescent; Adult; Aortic Valve Insufficiency; Female; Heart Auscultation; Heart Murmurs; Humans; Hypertension; Kidney Failure, Chronic; Male; Water-Electrolyte Balance
PubMed: 901686
DOI: 10.1136/hrt.39.8.900 -
Pediatric Cardiology Aug 2013Approximately 2 % of newborn infants are noted to have cardiac murmur on routine postnatal examination. Our aim was to look at current evidence and practice in the... (Review)
Review
Approximately 2 % of newborn infants are noted to have cardiac murmur on routine postnatal examination. Our aim was to look at current evidence and practice in the management of asymptomatic cardiac murmur in term neonates. We performed a systematic literature review and a telephone survey of all neonatal units in the United Kingdom (UK). The systematic review of the literature did not support the routine practice of four-limb blood pressure (BP), chest X-ray (CXR), and electrocardiogram (ECG) in the assessment of asymptomatic cardiac murmur in term neonates. The survey had participation from 132 (68 %) of 193 neonatal units in the UK. In an asymptomatic term neonate with cardiac murmur, 124 (94 %) units perform pulse oximetry, 100 units (76 %) measure four-limb BP, 36 units (27 %) perform a CXR, and 52 units (39 %) perform an ECG. Eight-six units (65 %) have availability of in-house echocardiography services provided mainly by paediatricians with cardiology interest in special care units and neonatologists in neonatal intensive care units. Currently there is wide variation in practice in the management of asymptomatic cardiac murmur in term neonates. There is no evidence to support the routine use of four-limb BP, CXR, and ECG in the assessment of asymptomatic cardiac murmur in term neonates. Based on the evidence available, both structured clinical examination (including determining presence and quality of bilateral femoral pulses) and universal use of pulse oximetry are most important in identifying CHD in asymptomatic term neonates with cardiac murmur before discharge home.
Topics: Disease Management; Echocardiography; Electrocardiography; Heart Murmurs; Humans; Incidence; Infant, Newborn; Intensive Care Units, Neonatal; United Kingdom
PubMed: 23475198
DOI: 10.1007/s00246-013-0668-6 -
Circulation Journal : Official Journal... May 2019
Topics: Aged; Aortic Valve Insufficiency; Aortic Valve Stenosis; Heart Murmurs; Humans; Male
PubMed: 30282849
DOI: 10.1253/circj.CJ-18-0697 -
Clinical Pediatrics Feb 2014Cardiac murmurs can be a source of anxiety for both physicians and parents until serious cardiac disorders are excluded. The innocent cardiac murmur is still the most...
Cardiac murmurs can be a source of anxiety for both physicians and parents until serious cardiac disorders are excluded. The innocent cardiac murmur is still the most common finding in healthy children and can usually be diagnosed through obtaining a complete history and performing a complete physical examination. However, a cardiac murmur may be the first sign of a structural cardiac disease and should not be ignored. Referral to a pediatric cardiologist for further evaluation is required when murmur assessment is not clear and diagnostic uncertainty is present. Educating and reassuring parents remains an important aspect of this evaluation. This article discusses features of innocent and pathological murmurs and provides an approach to cardiac murmurs in children.
Topics: Child; Diagnosis, Differential; Heart Diseases; Heart Murmurs; Humans; Infant; Infant, Newborn; Medical History Taking; Physical Examination; Referral and Consultation
PubMed: 23671266
DOI: 10.1177/0009922813488653 -
Pediatric Clinics of North America Dec 2004Cardiac auscultation remains a critical component of the pediatric examination and is the primary method of diagnosis for the common innocent murmurs of childhood. This... (Review)
Review
Cardiac auscultation remains a critical component of the pediatric examination and is the primary method of diagnosis for the common innocent murmurs of childhood. This article outlines the significance of auscultation and defines the skills important for the diagnosis and recognition of common cardiac murmurs in childhood. The origin of heart sounds and murmurs is reviewed, and an approach to pediatric murmur evaluation is presented. The seven innocent murmurs of childhood and adolescence are reviewed in detail. Further diagnostic evaluation and referral depends the clinician's confidence and experience in recognizing and correctly characterizing these murmurs.
Topics: Adolescent; Child; Clinical Competence; Coronary Circulation; Diagnosis, Differential; Heart Auscultation; Heart Murmurs; Humans
PubMed: 15561171
DOI: 10.1016/j.pcl.2004.08.004 -
The International Journal of... Apr 2015
Topics: Diastole; Echocardiography, Doppler, Color; Echocardiography, Doppler, Pulsed; Female; Heart Murmurs; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Mitral Valve; Phonocardiography; Predictive Value of Tests; Signal Processing, Computer-Assisted; Young Adult
PubMed: 25712167
DOI: 10.1007/s10554-015-0609-y -
Journal of Cardiothoracic and Vascular... Oct 2018
Topics: Aortic Valve Insufficiency; Diagnosis, Differential; Echocardiography, Transesophageal; Heart Murmurs; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Stenosis
PubMed: 29555389
DOI: 10.1053/j.jvca.2018.02.024 -
JAMA Cardiology Jul 2022
Topics: Echocardiography; Heart Murmurs; Humans; Male
PubMed: 35829714
DOI: 10.1001/jamacardio.2022.0927 -
The Journal of Small Animal Practice Aug 2022To determine the prevalence of iatrogenic heart murmurs in a population of apparently healthy cats and to investigate factors that may predispose cats to iatrogenic...
OBJECTIVES
To determine the prevalence of iatrogenic heart murmurs in a population of apparently healthy cats and to investigate factors that may predispose cats to iatrogenic murmurs.
MATERIALS AND METHODS
Apparently healthy cats presenting for routine examinations were prospectively enrolled. Following a physical examination to confirm there were no abnormalities, a cardiac examination was performed before and during a provocative manoeuvre performed independently by two clinicians. The provocative manoeuvre was performed on the right side of the chest wall by applying gentle pressure with a stethoscope to ascertain whether a murmur became audible, graded using a modified descriptive scale (soft/moderate). The cat's heart rate before and during the provocative manoeuvre and their age, sex, body condition score and bodyweight were recorded.
RESULTS
One hundred and six cats were prospectively enrolled. The average prevalence of iatrogenic murmurs was 28.2% with good interobserver agreement recorded on both the presence (kappa 0.67 and 0.62) and grade of the murmur (kappa 0.6 and 0.53). A significant association was noted between age and body condition score, with iatrogenic murmurs more likely in cats with increasing age and decreasing body condition score. There was no association between heart rate and the presence of an iatrogenic murmur.
CLINICAL SIGNIFICANCE
Iatrogenic murmurs are a common finding in cats with increasing prevalence noted in older and lean cats. Iatrogenic murmurs should therefore be considered as a differential diagnosis in a cat when an audible soft systolic right-sided murmur occurs with gentle pressure application to the chest wall during auscultation.
Topics: Animals; Cat Diseases; Cats; Echocardiography; Heart Murmurs; Iatrogenic Disease; Prevalence
PubMed: 35316860
DOI: 10.1111/jsap.13498 -
Proceedings of the Royal Society of... Apr 1950
Topics: Aorta; Aortic Valve Insufficiency; Auscultation; Heart; Heart Murmurs; Humans; Rheumatic Fever
PubMed: 15417580
DOI: No ID Found