| Pre-operative detection of valvular heart disease by anaesthetists. | |
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MedLine Citation:
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PMID: 16430564 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We prospectively estimated the prevalence of heart murmurs in 2522 consecutive adult non-cardiac surgery patients during pre-operative evaluation. Factors that contribute to the detection of a heart murmur were identified, and echocardiography was used to evaluate to what extent a murmur reflected presence of valvular heart disease. A cardiac murmur was detected in 106 patients (prevalence 4.2%, 95% CI: 3.5-5.1%). Multivariable logistic regression analyses showed that age and general physical impression were independently associated with detecting a murmur (p-values < 0.01). In 83 (79%) of the patients with a murmur, an echocardiographic diagnosis was available: 39% had aortic valve abnormalities, 24% had mitral valve regurgitation, 7% had other valvular heart disease and 30% did not have any abnormality. Thus, 58 of the 83 patients had valvular heart disease (positive predictive value using routine cardiac auscultation for diagnosing VHD: 70%, 95% CI: 59-79%). Murmurs in patients younger than 40 years never reflected valvular heart disease. Pre-operative cardiac auscultation seems only reasonable in patients aged 40 years or older. Subsequent echocardiography in these selected patients is necessary. |
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Authors:
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W A van Klei; C J Kalkman; M Tolsma; C L G Rutten; K G M Moons |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Anaesthesia Volume: 61 ISSN: 0003-2409 ISO Abbreviation: Anaesthesia Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-24 Completed Date: 2006-02-13 Revised Date: 2006-07-28 |
Medline Journal Info:
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Nlm Unique ID: 0370524 Medline TA: Anaesthesia Country: England |
Other Details:
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Languages: eng Pagination: 127-32 Citation Subset: AIM; IM |
Affiliation:
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University Medical Centre Utrecht, Department Peri-operative Care and Emergency Medicine, PO Box 85500, 3508 GA Utrecht, The Netherlands. w.a.vanklei@umcutrecht.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Anesthesiology / methods Anthropometry Aortic Valve Insufficiency / diagnosis Aortic Valve Stenosis / diagnosis Female Health Status Indicators Heart Auscultation Heart Murmurs / etiology Heart Valve Diseases / diagnosis*, ultrasonography Humans Logistic Models Male Middle Aged Mitral Valve Insufficiency / diagnosis Preoperative Care / methods Prospective Studies |
| Comments/Corrections | |
Comment In:
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Anaesthesia. 2006 Jul;61(7):718; author reply 718-9
[PMID:
16792627
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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