June 16, 1988New England Journal of Medicine
Bedside Diagnosis of Systolic Murmurs
Why the study?
Do bedside maneuvers accurately diagnose the cause of systolic murmurs in patients with documented systolic murmurs?
Population
50 patients with documented systolic murmurs
Comparison
Standard bedside maneuvers vs Comparison among different maneuvers and murmur…
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Maneuvers may aid bedside differentiation of systolic murmurs; leaves open prospective validation before routine adoption.
Structured PICO
Do bedside maneuvers accurately diagnose the cause of systolic murmurs in patients with documented systolic murmurs?
P
Population
50 patients with documented systolic murmurs
I
Intervention
Standard bedside maneuvers (inspiration, expiration, Valsalva maneuver, squatting-to-standing, standing-to-squatting, passive leg elevation, handgrip, transient arterial occlusion, inhalation of amyl nitrite)
C
Comparator
Comparison among different maneuvers and murmur origins
O
Outcome
Diagnostic accuracy (sensitivity and specificity) of bedside maneuvers for differentiating the origin of systolic murmurs
A combination of bedside maneuvers can accurately determine the origin of a systolic murmur, providing a valuable diagnostic tool in clinical examination.
Cite This Study
Lembo et al. (1988) studied this question.