Аудіо 00039. Aortic ejection murmur

Murmur since birth, ECG, chest radiograph and blood pressure measurements are normal. On auscultation a second-degree, rather coarse murmur that does not last throughout the entire systole is best heard on the left third intercostal space. Echocardiography is normal, the aortic valve is tricuspid, aortic flow velocity is 1.5 m/s. Apparently hyperkinesis intensified the murmur during examination, although pulse (approx. 70 bpm) and BP (100/70) were normal. In the phonogram and spectrogram the murmur is not clearly physiological but could be attributed to mild stenosis. Flow velocity of 1.5 m/s in the ascending aorta is within the normal range. Apparently this flow and consequent murmur are explained by a narrower than average ascending aorta. This type of auscultation finding should be examined with echocardiography for detection of minor aortic valvular defects. For example bicuspid aortic valve involves an increased risk of endocarditis even if it does not cause significant stenosis. Age 10.5 years. Area of auscultation: left third intercostal space.