title: [Echographic diagnosis of systolic murmur among 280 young French militaries. Implications for the expertise in military medicine].
abstract: Clinically discovering a systolic murmur is frequent among the young military population. When this murmur does not sound benign, a transthoracic echocardiography (TTE) is made to detect any cardiopathy, which could cause sudden cardiac death. The aim of this study was to evaluate the interest of systematic TTE in the assessment of any cardiac systolic murmur (CSM) among militaries.
  
  
  METHODS
  We ran a retrospective monocentric study in the "Clermont-Tonnerre" military hospital in Brest. We included all patients sent for TEE, aged 15 to 30 years old, from the 1st January 2010 until the 31st July 2013.
  
  
  RESULTS
  Two hundred and eighty TTES assessing CSM were performed. We found 28/280 (10%) echocardiographic abnormalities: 13 were bicuspid aortic valves (4.6%), 6 were ventricular septal defects (2.15%), 3 were atrial septal defects (1.07%), 4 were mild mitral regurgitations (1.43%), one mild pulmonary stenosis (0.35%) and one aortic stenosis (0.35%). No hypertrophic cardiomyopathy was found. Concerning military expertise, 11 (3.92%) patients among these 28 with abnormal TEE were considered unfit for work or "fit for work with limitations".
  
  
  CONCLUSIONS
  Assessing a cardiac systolic murmur with TEE lead to the diagnosis of a cardiomyopathy in 10% of the case. This study enhances the importance of systematic TEE when a CSM is detected in the young military, in order to determine if those soldiers can still fulfill their military duty.
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France. Electronic address: ulric.vinsonneau@orange.fr.
authors.forename: U
authors.initials: U
authors.lastname: Vinsonneau
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: L
authors.initials: L
authors.lastname: Vermeulen
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
authors.forename: V
authors.initials: V
authors.lastname: Griffet
authors.affiliation: Service de cardiologie, CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France.
authors.forename: A
authors.initials: A
authors.lastname: Delluc
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: N
authors.initials: N
authors.lastname: Paleiron
authors.affiliation: Service de cardiologie, CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Ven
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: G
authors.initials: G
authors.lastname: Rohel
authors.affiliation: Service de cardiologie, CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Jobic
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: M
authors.initials: M
authors.lastname: Piquemal
authors.affiliation: Service de cardiologie, CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France.
authors.forename: J
authors.initials: J
authors.lastname: Mansourati
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Clermont-Tonnerre, 41, rue Colonel-Fonferrier, 29240 Brest, France.
authors.forename: P
authors.initials: P
authors.lastname: Paule
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging; D000082882:Bicuspid Aortic Valve Disease; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006326:Heart Auscultation; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel / Q000706:statistics & numerical data; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D010173:Palpation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D054160:Systolic Murmurs / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: Adulte jeune; Military medicine; Médecine militaire; Souffle systolique; Systolic murmur; Transthoracic echocardiography; Young adult; Échographie trans-thoracique