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(Circulation. 1973;48:810.)
© 1973 American Heart Association, Inc.

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Doppler Echocardiography

The Localization of Cardiac Murmurs

STEVE L. JOHNSON M.D.¹; DONALD W. BAKER ¹; ROBERT A. LUTE ¹; HAROLD T. DODGE M.D.¹

¹ From the Center for Bioengineering and Department of Medicine (Division of Cardiology), University of Washington School of Medicine, Seattle, Washington.

A range-gated pulsed Doppler flowmeter has recently been developed that measures the average velocity of blood flow within a small tear-drop shaped (4 mm by 2 mm) sample volume. Unlike the continuous wave Doppler, the distance from the transducer face to the sampling site can be continuously varied by a range adjustment knob.

Twenty patients with cardiac murmurs were evaluated in a noninvasive laboratory by brief cardiac physical examination, abbreviated phonocardiogram, complete echocardiogram, and localization of the murmurs by Doppler echocardiography. The localization depends on the detection of turbulent flow or jets at the sampling site. The murmurs included the diastolic rumble of mitral stenosis, mitral regurgitation, the murmur of left ventricular outflow tract obstruction, aortic stenosis, aortic insufficiency, diastolic rumble of tricuspid stenosis, augmented right ventricular filling sound in atrial septal defects, pulmonic stenosis, pulmonic insufficiency, and high velocity flow through the obstruction in ccarctation of the aorta.

Key Words: Mitral stenosis • Pulmonic stenosis • Mitral regurgitation • Pulmonic insufficiency • Aortic insufficiency • Atrial septal defects • Coarctation of aorta • Tricuspid stenosis • Phonocardiography • Aortic stenosis

Submitted on April 12, 1973
Accepted on June 13, 1973

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