The prevalence of valvular abnormalities in patients who were referred for echocardiographic examination with a primary diagnosis of "heart murmur".
BACKGROUND
The prevalence of valvular abnormality and innocent murmur in patients who are referred for echocardiographic evaluation with the diagnosis of "murmur" is not known. The goal of this study was to evaluate the prevalence of valvular abnormalities in such patients.


METHODS
We retrospectively reviewed the echocardiograms that were referred with the primary ordering diagnosis of "murmur," for the presence of valvular abnormalities. For comparison, we used other documented primary reasons for echocardiographic referral, such as chest pain, shortness of breath, etc.


RESULTS
In this cohort, 7,684 echocardiogram reports documented primary diagnostic reasons for echocardiographic referral. A total of 3,460 echocardiogram reports (45%) were coded "murmur" as the primary reason for the study referral. There was a higher prevalence of female patient referrals for heart murmur evaluation (61.8% vs. 38.2%). Although, patients with murmur had a higher prevalence of valvular abnormalities, compared to other reasons for echocardiographic examination, the prevalence of valvular abnormality was less than 50% (48.6% vs. 35.5%) in both groups. Despite the higher number of female patients referred with the diagnosis of murmur, the percentage of abnormal valves was lower in women (45.6% vs. 53.4% in men).


CONCLUSIONS
The prevalence of valvular abnormalities in patients who were referred with the diagnosis of murmur for echocardiographic examination was less than 50%, with a lesser degree found in women. Routine utilization of echocardiography for evaluation of all murmurs may be unwarranted.
Movahed
Mohammad-Reza
MR
Department of Medicine, Sarver Heart Center, University of Arizona Medical Center, Tucson, Arizona 85724, USA. rmovahed@email.arizona.edu
Ebrahimi
Ramin
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D004452:Echocardiography; D005260:Female; D006337:Heart Murmurs / Q000175:diagnosis / Q000209:etiology*; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation; D012107:Research Design; D012189:Retrospective Studies