Why the study?
Does clinical context (symptom status, prior knowledge of diagnosis) affect the detection of the murmur of advanced aortic stenosis?
Does clinical context (symptom status, prior knowledge of diagnosis) affect the detection of the murmur of advanced aortic stenosis?
Clinical context, such as symptom status and prior knowledge of the diagnosis, significantly influences the likelihood of detecting a murmur in patients with advanced aortic stenosis.
Clinical context may bias AS murmur detection; leaves open need for blinded validation studies.
OBJECTIVES: Auscultation is an important clue to the presence of aortic stenosis (AS). We sought to assess the effect of symptom status, prior knowledge of diagnosis, and other patient factors on murmur detection. METHODS: Patients with moderate-to-severe AS by echocardiography at a single center between June 2015 and June 2016 were included. Five consecutive patient encounters (inpatient and outpatient) within 12 months before the echocardiogram were analyzed. CONCLUSIONS: In this real-world assessment, clinical context played an important role in the auscultation of AS murmur. The findings have important implications for the clinical diagnosis of asymptomatic advanced AS.
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Kattoor et al. (2018) studied this question.
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