Elsevier

American Heart Journal

Volume 64, Issue 2, August 1962, Pages 149-158
American Heart Journal

Clinical communication
The significance of aortic ejection systolic murmurs

https://doi.org/10.1016/0002-8703(62)90327-7Get rights and content

Abstract

The clinical features of an isolated aortic ejection systolic murmur are described, and the differentiation from other systolic murmurs is discussed.

It is postulated that, in the absence of hypertension, such an aortic ejection systolic murmur is seldom or never “functional” and invariably implies that a congenital bicuspid valve, minimal disease of the valve, or a dilated aorta is present.

Evidence is produced which suggests that 20 normotensive patients, under the age of 35 years, with aortic ejection systolic murmurs have abnormal aortic valves.

Four hundred normal subjects, including 200 children, 100 young adults, and 100 pregnant women, were auscultated in order to assess the incidence of an isolated aortic systolic murmur; such a murmur was present in only one instance. This was in a 20-year-old man, and it seems likely that he has a congenital bicuspid aortic valve.

The recognition of an abnormal, even though not stenotic, aortic valve in young people is important, particularly in relation to the prophylaxis of rheumatic fever and subacute bacterial endocarditis. The possible development in later life of calcific aortic stenosis in some subjects, particularly males, with bicuspid valves should be borne in nind.

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