Diagnostic reliability of M-mode echocardiography for detecting mitral valve prolapse in 50 consecutive panic patients.
Fifty consecutive panic patients had M-mode echocardiographs read independently by two cardiologists with expertise in echocardiography. In this prospective study, there was poor interrater reliability (22 of 50; K = 0.11) for diagnosis of mitral valve prolapse (MVP). On repeat evaluation 10 months later there was also unacceptable intrarater reliability for each reader: 22 of 35 (K = 0.41) and 22 of 35 (K = 0.45). We conclude that M-mode echocardiography is clinically unreliable for establishing the diagnosis of mitral valve prolapse. These findings suggest that the variable reporting of M-mode-determined mitral valve prolapse in psychiatric populations may reflect differences among echocardiologists rather than differences in cardiac pathology. The clinical implications of these findings are discussed.
Dager
S R
SR
Department of Psychiatry, University of Washington, Seattle 98104.
Comess
K A
KA
Saal
A K
AK
Sisk
E J
EJ
Beach
K W
KW
Dunner
D L
DL
D000379:Agoraphobia / Q000175:diagnosis; D001143:Arousal; D003866:Depressive Disorder / Q000175:diagnosis; D004452:Echocardiography; D005239:Fear; D006801:Humans; D008943:Mitral Valve / Q000473:pathology; D008945:Mitral Valve Prolapse / Q000175:diagnosis* / Q000523:psychology; D010200:Panic; D011446:Prospective Studies