Intensity of murmurs correlates with severity of valvular regurgitation

doi:10.1016/S0002-9343(97)89452-1

The American Journal of Medicine

Volume 100, Issue 2, February 1996, Pages 149-156

https://doi.org/10.1016/S0002-9343(97)89452-1 Get rights and content

Purpose

To evaluate the relationship between the intensity of murmurs and severity of mitral and aortic regurgitation.

Patients and methods

Consecutive patients with chronic isolated aortic (n = 40) or mitral (n = 170) regurgitation undergoing echocardiographic quantitation of regurgitation between 1990 and 1991 were studied. Regurgitant volume and fraction were measured using two simultaneous methods (quantitative Doppler echocardiography and quantitative two-dimensional echocardiography); the intensity of the regurgitant murmur (grade 0 to 6) was noted by physicians unaware of the study.

Results

Correlations between murmur intensity and regurgitant volume and fraction were good in aortic regurgitation (r =.60 and r = 67, respectively; P <0.001) and mitral regurgitation (r = 64 and r = 67, respectively; P <0.001) but weaker (r = 47 and r = 45, respectively) in the subset of mitral regurgitation of ischemic or functional cause. Murmur intensity grades >3 for aortic regurgitation and >4 for mitral regurgitation predicted severe regurgitation (regurgitant fraction >40%) in 71% and 91% of patients, respectively. Murmur grades <1 for aortic regurgitation and <2 for mitral regurgitation predicted “not severe” regurgitation in 100% and 88% of patients, respectively. Murmur grades 2 for aortic regurgitation and 3 for mitral regurgitation were not correlated to degree of regurgitation. The severity of regurgitation was the most powerful determinant of intensity of murmur.

Conclusions

Murmur intensity correlates well with the degree of chronic organic aortic and mitral regurgitation, and can be used as a predictor of regurgitation severity and as a simple guideline for diagnostic testing in these patients.

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View full text

Intensity of murmurs correlates with severity of valvular regurgitation

Purpose

Patients and methods

Results

Conclusions

J Am Soc Echocardiogr.

Am J Cardiol.

J Am Coll Cardiol.

Am J Cardiol.

J Am Coll Cardiol.

J Am Coll Cardiol.

Prog Cardiovasc Dis.

J Am Coll Cardiol.

Am Heart J.

J Am Coll Cardiol.

J Am Coll Cardiol.

J Am Soc Echocardiogr.

J Cardiol.

Am J Cardiol.

Rheumatic fever and other rheumatic disease of the heart

Detection of aortic insufficiency by standard echocardiography, pulsed Doppler echocardiography, and auscultation: a comparison of accuracies

Ann Intern Med.

Diagnosis of aortic insufficiency: comparison of auscultation and M-mode echocardiography to angiography South Med

J.

Diagnostic accuracy of auscultation in aortic regurgitation

J Am Coll Cardiol.

Prevalence of regurgitant murmurs in patients with valvular regurgitation detected by Doppler echocardiography

Ann Intern Med.

Bedside Cardiology

Impact of impinging wall jet on color Doppler quantification of mitral regurgitation

Circulation

Quantification of mitral valvular incompetence

Cathet Cardiovasc Diagn.