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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Murmur, Diastolic
David Cescon, Edward Etchells, Eugene Oddone
Make the Diagnosis: Murmur, Diastolic


Topics Discussed: angiogram, aortic valve insufficiency, criterion standard comparisons (diagnostic tests), diastolic murmur, echocardiography, likelihood ratio, make the diagnosis, prior probability, rheumatic fever, third heart sound

Excerpt: "One study of randomly selected elderly (75-86 years old) Finnish persons found a 29% prevalence of mild or greater AR.5 Evaluation of more than 3000 men and women (aged 54 ± 10 years) in the Framingham heart study detected AR of trace or greater severity in 13.0% of men and 8.5% of women.6 Increasing age was associated with higher prevalence of AR. ..."
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