Key result
Cardiac auscultation detected only 51.6% of mitral valve lesions and 56.6% of aortic valve lesions identified by echocardiography, with inaudible murmurs linked to mild lesions (p=0.001).
Why the study?
Does cardiac auscultation accurately detect mitral and aortic valve disease compared to transthoracic echocardiography in patients with heart valve disease?
Cross-Sectional (n=300)
No
Does cardiac auscultation accurately detect mitral and aortic valve disease compared to transthoracic echocardiography in patients with heart valve disease?
Approximately half of valve diseases detected by echocardiography are clinically silent on auscultation, highlighting the limitations of physical examination alone.
Auscultation misses nearly half of valve lesions; leaves open whether echocardiography should replace it for adult screening.
Aims: Auscultation is a straight forward and inexpensive method for the preliminary diagnosis of heart valve disease. However, many valve diseases are clinically silent and therefore echocardiography may be the preferred option. In this prospective study we aimed to investigate the sensitivity of auscultation in patients with mitral and aortic valve disease in comparison to Doppler echocardiography.Methods: 300 consecutive patients with heart valve disease who attended the echocardiography department at Erbil Cardiac Centre between May 2015 and February 2016 were included in this study. Patients were excluded if they were under 15 years of age, had poor window echocardiography, had prosthetic aortic and/or mitral valves, had a history of infective endocarditis, were pregnant or had congenital heart diseases. All of the included patients underwent cardiac auscultation of the mitral and aortic valve, which was carried out by 2 experienced cardiologists. All of these patients were then investigated by transthoracic echocardiography.Results: 215 mitral valve lesions and 122 aortic valve lesions were detected by echocardiography. The most common lesion detected was mitral regurgitation followed by aortic regurgitation, aortic stenosis and mitral stenosis. Auscultation was only able to detect 51.6% of the mitral valve lesions and 56.6% of the aortic valve lesions. There was a significant association between inaudible murmurs and mild valve lesions on echocardiography (p = 0.001) and between inaudible murmurs and systolic dysfunction as identified by echocardiography (p = 0.001).Conclusions: Approximately half of the valve diseases detected by echocardiography were silent clinically.
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King et al. (2017) conducted a cross-sectional in Heart valve disease (n=300). Cardiac auscultation vs. Transthoracic echocardiography was evaluated on Detection of mitral and aortic valve lesions. Cardiac auscultation detected only 51.6% of mitral valve lesions and 56.6% of aortic valve lesions identified by echocardiography, with inaudible murmurs linked to mild lesions (p=0.001).
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