The not so innocent heart murmur: a 5-year experience

Area of Science:

• Cardiology
• Clinical Medicine

Background:

• Auckland City Hospital established a Heart Murmur Clinic (HMC) to assess asymptomatic systolic murmurs.
• The clinic aims for early intervention or reassurance for structural heart disease.
• The benefit of HMCs in adults was previously unclear.

Purpose of the Study:

• Review clinical demographics and echocardiographic data of HMC patients.
• Determine the prevalence of significant structural heart disease.
• Identify common structural abnormalities in adult patients with murmurs.

Main Methods:

• Retrospective review of 1221 adult patients (≥15 years) presenting with asymptomatic systolic murmurs.
• Data collected between March 2010 and December 2015.
• Excluded patients with prior cardiac surgery or known heart disease.

Main Results:

• Significant cardiac disease found in 156 patients (12.8%); 23 required surgery.
• Most common pathologies: aortic stenosis (43) and mitral regurgitation (48).
• Older patients (>65 years) showed a higher prevalence of structural heart disease (16% vs 11%).

Conclusions:

• The HMC effectively screens patients with low assessment priority.
• A significant proportion of patients had actionable structural heart disease.
• Early detection and intervention via HMC may improve patient outcomes.