[Heart murmur and echocardiographic findings in 2,907 non-selected patients admitted to hospital].
BACKGROUND
Since the introduction and increased availability of echocardiography, the importance of heart auscultation in diagnosing valvular heart disease has been reduced. Nevertheless, auscultation is still important when deciding whether to refer a patient for further examination.


METHODS
A retrospective analysis was done of 2,907 consecutive patients admitted to a hospital in Copenhagen from 1 April 1998 to 31 March 1999. Auscultation, clinical history and echocardiography were performed within 24 hours of admittance.


RESULTS
The prevalence of heart murmurs was 20.5%. The sensitivity and specificity of murmur found by auscultation and echocardiographic findings were 0.52 and 0.93, respectively. We found a positive predictive value of auscultation of 0.76 and a negative predictive value of 0.82.


CONCLUSIONS
The relationship between auscultation and echocardiography in diagnosing heart murmurs in non-selected patients admitted to hospital has not previously been described. Auscultation has a high specificity, indicating that such patients should be referred for echocardiography. Its sensitivity, however, is low, indicating that it is insufficient as a means of screening for valvular heart disease.
Iversen
Kasper Karmark
KK
Amager Hospital, Kardiologisk Klinik B, H:S Rigshospitalet, DK-2100 København Ø. kasper.iversen@dadlnet.dk
Teisner
Ane S
AS
Bay
Morten
M
Kirk
Vibeke
V
Boesgaard
Søren
S
Nielsen
Henrik
H
D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006326:Heart Auscultation / Q000592:standards*; D006337:Heart Murmurs / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity