Systolic ejection murmurs in the elderly: Aortic valve and carotid arteries echo-Doppler findings

C. Vigna, M. Impagliatelli, A. Russo, M. Pacilli, V. De Rito, G. P. Perna, A. Villella, T. Langialonga, R. Fanelli, G. Rinelli, A. Lombardo, F. Loperfido

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Abstract

Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients > sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48%) and 2 Group 2 (9%) patients (p <0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p <0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43%); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p <0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18%); in these 4, ipsilateral obstructive CA were found. Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.

Original languageEnglish
Pages (from-to)455-461
Number of pages7
JournalAngiology
Volume42
Issue number6
Publication statusPublished - 1991

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Systolic Murmurs
Aortic Valve
Carotid Arteries
Neck
Carotid Stenosis
Aortic Valve Stenosis
Thoracic Aorta
Color

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Vigna, C., Impagliatelli, M., Russo, A., Pacilli, M., De Rito, V., Perna, G. P., ... Loperfido, F. (1991). Systolic ejection murmurs in the elderly: Aortic valve and carotid arteries echo-Doppler findings. Angiology, 42(6), 455-461.

Systolic ejection murmurs in the elderly : Aortic valve and carotid arteries echo-Doppler findings. / Vigna, C.; Impagliatelli, M.; Russo, A.; Pacilli, M.; De Rito, V.; Perna, G. P.; Villella, A.; Langialonga, T.; Fanelli, R.; Rinelli, G.; Lombardo, A.; Loperfido, F.

In: Angiology, Vol. 42, No. 6, 1991, p. 455-461.

Research output: Contribution to journalArticle

Vigna, C, Impagliatelli, M, Russo, A, Pacilli, M, De Rito, V, Perna, GP, Villella, A, Langialonga, T, Fanelli, R, Rinelli, G, Lombardo, A & Loperfido, F 1991, 'Systolic ejection murmurs in the elderly: Aortic valve and carotid arteries echo-Doppler findings', Angiology, vol. 42, no. 6, pp. 455-461.
Vigna C, Impagliatelli M, Russo A, Pacilli M, De Rito V, Perna GP et al. Systolic ejection murmurs in the elderly: Aortic valve and carotid arteries echo-Doppler findings. Angiology. 1991;42(6):455-461.
Vigna, C. ; Impagliatelli, M. ; Russo, A. ; Pacilli, M. ; De Rito, V. ; Perna, G. P. ; Villella, A. ; Langialonga, T. ; Fanelli, R. ; Rinelli, G. ; Lombardo, A. ; Loperfido, F. / Systolic ejection murmurs in the elderly : Aortic valve and carotid arteries echo-Doppler findings. In: Angiology. 1991 ; Vol. 42, No. 6. pp. 455-461.
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abstract = "Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients > sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48{\%}) and 2 Group 2 (9{\%}) patients (p <0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p <0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43{\%}); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p <0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18{\%}); in these 4, ipsilateral obstructive CA were found. Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.",
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T2 - Aortic valve and carotid arteries echo-Doppler findings

AU - Vigna, C.

AU - Impagliatelli, M.

AU - Russo, A.

AU - Pacilli, M.

AU - De Rito, V.

AU - Perna, G. P.

AU - Villella, A.

AU - Langialonga, T.

AU - Fanelli, R.

AU - Rinelli, G.

AU - Lombardo, A.

AU - Loperfido, F.

PY - 1991

Y1 - 1991

N2 - Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients > sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48%) and 2 Group 2 (9%) patients (p <0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p <0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43%); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p <0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18%); in these 4, ipsilateral obstructive CA were found. Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.

AB - Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients > sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48%) and 2 Group 2 (9%) patients (p <0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p <0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43%); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p <0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18%); in these 4, ipsilateral obstructive CA were found. Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.

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