Importance of Aortic Dilatation in the Genesis of the Innocent Systolic Ejection Murmur of the Aged

Abstract

Aortic systolic murmurs and aortic dilatation were studied in a randomized sample of 100 hospital patients over the age of 60. Clinical, phonocardiographic, radiologic and carotid-pulse data provided the basis for graphic characterization of the murmurs. Senile aortic dilatation was common (66 patients). In a high percentage (39 patients), dilatation of the ascending aorta (and sometimes of the arch) was associated with an aortic systolic murmur. The "innocent" type was always associated with aortic dilatation. This "innocent murmur of the aged", even though caused by structural alterations, should be considered in the same light as the "innocent murmur of children", as it is not associated with dynamic embarrassment of the circulation.

Clinical evaluation of the 3M Littmann Electronic Stethoscope Model 3200 in 150 cats

“…Specific echocardiographic findings that could account for a cardiac murmur were noted, including: (i) regurgitant blood flow; (ii) dynamic left or right ventricular outflow obstruction; (iii) turbulent or accelerated blood flow; or (iv) aortic root dilation. [17][18][19][20][21] Specific echocardiographic abnormalities that would be associated with left ventricular diastolic dysfunction and a gallop sound included: (i) evidence of left ventricular hypertrophy; (ii) abnormal transmitral flow patterns; (iii) reduced pulse wave tissue Doppler velocity of mitral annular motion indicating delayed relaxation; or (iv) increased left atrial size in the absence of mitral regurgitation. The results of echocardiography were recorded without knowledge of the auscultatory findings.…”

Evaluation of the Systolic Murmur in the Elderly

“…Of 100 patients suitable for inclusion, 30 percent had a Grade I or Grade II systolic murmur. In another study, 39 percent of 100 elderly subjects drawn randomly from hospital wards and without known rheumatic, syphilitic or calcific aortic lesions were found to have a basal systolic murmur (6). Electrocardiographic evidence of old myocardial infarction and moderate hypertension were allowed in selection of the subjects.…”