Nonspecific systolic murmurs: an audit of the clinical value of echocardiography.

AIM: To evaluate the clinical use of echocardiography in patients with nonspecific systolic murmurs.

METHODS: Analysis of request forms and echocardiogram reports in a consecutive series of scans done for patients with nonspecific systolic murmurs between 1984 and 1991.

RESULTS: Normal cardiac structure and function were found in: (1) 62% of 565 studies done for patients with nonspecific systolic murmurs; (2) 96% of 69 scans in patients with clinical diagnosis of a benign murmur and (3) 93% of 45 pregnant women with nonspecific systolic murmurs. No echocardiographic abnormalities were detected in 76% of studies done for patients aged between 1 and 50 yr. Congenital heart disease was found in 39% of patients with nonspecific systolic murmurs aged between 0 and 1 yr. Mitral regurgitation was found in 33% and aortic valve disease in 22% of nonspecific systolic murmurs patients aged over 60 yr.

CONCLUSIONS: Echocardiography rarely revealed significant abnormalities in the assessment of patients with nonspecific systolic murmurs aged between 1 and 50 yr, especially when the test was used to confirm the clinical suspicion that the heart was normal. Ultrasound scanning was useful in the assessment of nonspecific murmurs in patients aged 0-1 yr or over 50 yr, particularly those over 60 yr.