SYSTOLIC MURMURS IN APPARENTLY HEALTHY INDIVIDUALS

Presence of a systolic murmur is not always indicative of organic heart disease or abnormality, especially so in asymptomatic individuals. We studied 210 young adults (192 males, 18 females) of the age group 16 to 23 years with systolic murmurs to evaluate the utility of noninvasive tests in ascertaining the presence or absence of heart disease. Each case was categorized after clinical evaluation and again after noninvasive investigations (chest radiogram, 12 lead ECG, and echocardiography) into 3 groups. Based on clinical evaluation alone, 190 (90.5%) cases had no evidence of heart disease (group A), 16 (7.6%) cases had definite heart disease (group C) and in 4 (1.9%) cases the presence of heart disease could not be ruled out definitely (group B). The recategorization after investigations did not alter the initial diagnosis in any of the subjects from groups A and C (98.1%). Two cases from group B (0.95%) changed groups whereas in the remaining 2 cases (0.95%) from group B no definite conclusions could be reached even after echocardiography.