title: Doppler echocardiography in elderly patients with ejection systolic murmurs.
abstract: Thirty-nine elderly patients, mean age 77 years (range 65 to 96), with ejection systolic murmurs were studied to evaluate the functional significance of these murmurs. Subjects were evaluated clinically, by 2-D echocardiography, and by a full Doppler echocardiography study. Good quality Doppler signals were obtained in 35 subjects. Mitral regurgitation was found to be the only significant valvular lesion in 6 patients (17%). Doppler gradients in systole across the aortic valve were less than 30 mmHg in 28 subjects (80%) and were considered not significant. Gradients of greater than 30 mmHg representing significant aortic stenosis were found in 7 subjects (20%). The clinical sensitivity in detecting significant aortic stenosis was 44% and specificity was 81%. Doppler evidence of significant aortic stenosis was found in a substantial proportion of these elderly subjects. Neither clinical assessment nor 2-D echocardiography can be relied on to exclude this condition.
authors.affiliation: Department of Medicine, Victoria Infirmary, Glasgow, UK.
authors.forename: G M
authors.initials: GM
authors.lastname: McKillop
authors.forename: D A
authors.initials: DA
authors.lastname: Stewart
authors.forename: J M
authors.initials: JM
authors.lastname: Burns
authors.forename: D
authors.initials: D
authors.lastname: Ballantyne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications*; D015150:Echocardiography, Doppler; D006337:Heart Murmurs / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications; D012680:Sensitivity and Specificity; D013599:Systole / Q000502:physiology