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BioMed Research International 2022Most researchers use features of diastolic murmurs to identify coronary artery disease. However, the diastolic murmurs of coronary artery disease are usually very weak...
Most researchers use features of diastolic murmurs to identify coronary artery disease. However, the diastolic murmurs of coronary artery disease are usually very weak and are easily contaminated by noise and valvular murmurs. Therefore, the diagnostic accuracy of coronary artery disease when only using diastolic murmurs is not well. An algorithm for improving the accuracy in the identification of coronary artery disease by combining the features of the first heart sound and diastolic murmurs was proposed. Firstly, a first heart sound feature extraction algorithm was used to identify coronary artery disease from noncoronary artery disease. Secondly, the Empirical Wavelet Transform algorithm was used to decompose the diastolic heart sound into three modes, and the spectral energy of each mode was calculated to distinguish coronary artery disease from noncoronary artery disease. Then, the features of the fist heart sound, the second diastolic spectral energy, and the parameter P3, which was used to discriminate the diastolic murmurs in coronary artery disease and in valvular disease, were combined together to improve the diagnostic accuracy of coronary artery disease. The comparison experiment results show that the accuracy of the proposed algorithm is superior to some state-of-the-art methods when they are used to diagnose coronary artery disease.
Topics: Algorithms; Coronary Artery Disease; Heart Murmurs; Heart Sounds; Humans; Wavelet Analysis
PubMed: 35252442
DOI: 10.1155/2022/3058835 -
The Veterinary Record Apr 2022Spontaneous week-to-week variation in the presence and intensity of innocent cardiac murmurs in individual puppies is unknown.
BACKGROUND
Spontaneous week-to-week variation in the presence and intensity of innocent cardiac murmurs in individual puppies is unknown.
METHODS
Sixty privately owned, clinically healthy Cairn terrier and Dachshund puppies between 4 and 8 weeks of age were included. All dogs underwent weekly cardiac auscultation at the breeders' home by a veterinary cardiology specialist using an acoustic stethoscope. On each occasion, a phonocardiogram was recorded with an electronic stethoscope. Furthermore, all dogs were auscultated once at a first opinion veterinary practise and once at the authors' institution, where they also underwent an echocardiographic examination.
RESULTS
Two-hundred and eighty-one auscultations were conducted on 32 Cairn terriers and 28 Dachshunds, at the breeders' homes. Innocent murmurs were detected in 19 puppies. Two of these puppies had a detectable murmur on each auscultation. In five of the puppies, the murmur became undetectable during the observation period and in 12 puppies the murmur was intermittently audible. Auscultation at the authors' institution had an unpredictable effect on murmur presence and intensity. Phonocardiography revealed murmurs in 42 puppies. Interpretation of phonocardiograms by two independent observers showed nearly perfect agreement (κ = 0.859).
CONCLUSIONS
Remarkable and unpredictable spontaneous week-to-week variation was documented in the presence and intensity of innocent murmurs.
Topics: Animals; Dogs; Echocardiography; Heart Auscultation; Heart Murmurs; Stethoscopes
PubMed: 34807995
DOI: 10.1002/vetr.1173 -
The Practitioner Jun 2000
Review
Topics: Adult; Aged; Aortic Valve Stenosis; Electrocardiography; Family Practice; Female; Heart Murmurs; Humans; Male; Middle Aged; Mitral Valve Insufficiency; Pulse; Referral and Consultation
PubMed: 10962847
DOI: No ID Found -
Canadian Family Physician Medecin de... Sep 1995Nearly all pediatric murmurs are heard in normal hearts and are not due to cardiac disorders. These murmurs usually can be classified by distinctive features and... (Review)
Review
Nearly all pediatric murmurs are heard in normal hearts and are not due to cardiac disorders. These murmurs usually can be classified by distinctive features and distinguished from organic murmurs by skillful clinical examination. This article reviews the various types of innocent heart murmurs in children, discusses their differential diagnoses, and suggests an approach to sorting out pediatric murmurs.
Topics: Child, Preschool; Diagnosis, Differential; Family Practice; Heart Murmurs; Heart Sounds; Humans; Infant; Infant, Newborn; Medical History Taking; Physical Examination; Referral and Consultation
PubMed: 8520239
DOI: No ID Found -
The American Journal of the Medical... May 1963
Topics: Aortic Valve; Aortic Valve Insufficiency; Bicuspid Aortic Valve Disease; Heart Defects, Congenital; Heart Murmurs; Heart Valve Diseases; Humans; Sternum
PubMed: 13960803
DOI: No ID Found -
Canadian Family Physician Medecin de... Feb 2003To compare cardiac physical examination with echocardiography for evaluating systolic murmurs. (Comparative Study)
Comparative Study Review
OBJECTIVE
To compare cardiac physical examination with echocardiography for evaluating systolic murmurs.
QUALITY OF EVIDENCE
Three databases were searched for studies comparing echocardiography and auscultation as to sensitivity and diagnostic accuracy: MEDLINE (Ovid Online), EMBASE, and Current Contexts. The quality of reported data is lowered by subjective interpretation of results of both cardiac physical examination and echocardiography, especially Doppler colour flow imaging.
MAIN MESSAGE
In adults, functional systolic murmurs can usually be distinguished from organic murmurs. Pathologic murmurs frequently have one or more associated clinical abnormalities. If a clinician determines a murmur is benign, results of echocardiography are very likely to be normal, especially in young and middle-aged adults. According to current guidelines, echocardiography should not be ordered for "innocent" systolic murmurs in patients who are asymptomatic and have otherwise normal findings on examination. If patients with functional systolic murmurs could be identified and not routinely referred for echocardiography, great cost savings could be realized.
CONCLUSION
Echocardiography is not required for all patients with systolic murmurs and should not replace cardiac physical examination.
Topics: Adult; Echocardiography; Echocardiography, Doppler, Color; Family Practice; Heart Auscultation; Heart Murmurs; Humans; Middle Aged; Sensitivity and Specificity; Systole
PubMed: 12619738
DOI: No ID Found -
Recenti Progressi in Medicina Dec 2014Cardiac auscultation permits to distinguish between the innocent heart murmurs and pathologic murmurs; characteristics of pathologic murmurs include a holosystolic or... (Review)
Review
Cardiac auscultation permits to distinguish between the innocent heart murmurs and pathologic murmurs; characteristics of pathologic murmurs include a holosystolic or diastolic murmur, maximal murmur intensity at the upper left sternal border and increased intensity when the patient stands. Murmurs should be described by their timing in the cardiac cycle, intensity, shape, pitch, location, radiation, and response to dynamic maneuvers. When the medical history and physical examination support the diagnosis of innocent heart murmur, neither further investigation nor referal is indicated. On the contrary, echocardiography is recommended for patients with any other abnormal physical examination findings that increase the likelihood of structural heart disease. In this review we discuss the definition and classification of murmurs, how to evaluate it.
Topics: Child; Echocardiography; Heart Auscultation; Heart Murmurs; Humans; Systolic Murmurs
PubMed: 25533235
DOI: 10.1701/1706.18620 -
International Journal of Cardiology Jun 2009
Topics: Heart Murmurs; Humans; Severity of Illness Index; Systole
PubMed: 19215992
DOI: 10.1016/j.ijcard.2008.11.212 -
Journal of Veterinary Cardiology : the... Aug 2018Cardiac murmurs were first described approximately 200 years ago. Subsequently, various clinicians, starting with Samuel Levine, have proposed grading schemes, depicting... (Review)
Review
Cardiac murmurs were first described approximately 200 years ago. Subsequently, various clinicians, starting with Samuel Levine, have proposed grading schemes, depicting intensity, or other murmur characteristics, in an attempt to differentiate pathological and physiological murmurs or different degrees of pathology. In the 1960s, these schemes were adapted by veterinary cardiologists and have been used over the last 50 years. However, the clinical utility of these schemes has only recently been examined in veterinary medicine (and never examined in humans), and these studies suggest that the current, commonly used murmur grading scheme is unnecessarily complex and contains redundant information. A simpler, more intuitive grading scheme might achieve the same desired outcome as the more complex scheme, potentially with less confusion. This review examines the history of murmur grading and proposes a reconsideration of the current grading scheme to improve clinical communication.
Topics: Animals; Dog Diseases; Dogs; Fatty Acid Binding Protein 3; Heart Diseases; Heart Murmurs; History, 19th Century; History, 20th Century; Humans
PubMed: 30017853
DOI: 10.1016/j.jvc.2018.06.001 -
Heart Disease and Stroke : a Journal... 1993
Topics: Cardiomyopathy, Hypertrophic; Coronary Circulation; Heart Murmurs; Heart Valve Diseases; Humans; Systole
PubMed: 8149094
DOI: No ID Found