Prevalence
Causes
Clinical
features
Differential
diagnosis
Investigations
Therapy
Prevention
Prognosis
|  | | | Clinical
features |
Look for evidence of mitral regurgitation
b
-
listen for a late or pansystolic murmur in the mitral area
-
listen for any increase on transient arterial occlusion.
(Inflate a blood pressure cuff around both arms simultaneously inflated to 20-40 mmHg > systolic
BP, and check the murmur intensity 20 seconds later.)
Why?
A murmur in the mitral area makes mitral regurgitation more likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
LR-
(95% CI)
|
Post-test Probability |
|
systolic murmur
b
(pre-test probability: 13%)
|
mitral regurgitation
(echocardiogram)
|
murmur in mitral area
|
3.9
(3.0 to
5.1)
|
37% |
0.34
|
5% |
|
|
|
late/pansystolic murmur
|
1.8
(1.2 to
2.5)
|
21% |
0.0
(0.0 to
0.8)
|
0% |
|
|
|
transient arterial occlusion causing an increase in murmur intensity
|
7.5
(2.5 to
23)
|
53% |
0.28
(0.18 to
0.60)
|
4% |
|
internal medicine