Valvular & structural heart disease
Heart murmurs in the general population: diagnostic value and prevalence from the Tromsø Study
Authors' conclusion
In this general adult population, heart auscultation by GPs identified murmurs in nearly one in four individuals and showed high specificity but limited sensitivity for diagnosing VHD.
Study context
- Population
- General adult population aged ≥40 years, Seventh Tromsø Study (2015–2016)mean age 63 years
- Participants
- 2,082 participants
- Comparison
- Heart auscultation by general practitioners (GPs) vs echocardiography
- Diastolic murmursn = 9
- Outcome
- Prevalence and diagnostic accuracy of heart murmurs for clinically significant VHD (≥mild AS or ≥moderate AR or MR), echocardiography as reference
Methodological detailspopulation-based, GPs blinded to echocardiographic results
- Population-based
- GPs blinded to echocardiographic results
Performance
As reported in the abstract
| Test or model | Sensitivity, aortic stenosis (AS) | Sensitivity, aortic regurgitation (AR) | Sensitivity, mitral regurgitation (MR) | Specificity, AS | Specificity |
|---|---|---|---|---|---|
| Systolic murmurs | 100% | 43% | 29% | 78% | — not stated in the abstract |
| Diastolic murmurs | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | >99% |
Sensitivity, aortic stenosis (AS)
Systolic murmurs100%
Diastolic murmurs— not stated in the abstract
Sensitivity, aortic regurgitation (AR)
Systolic murmurs43%
Diastolic murmurs— not stated in the abstract
Sensitivity, mitral regurgitation (MR)
Systolic murmurs29%
Diastolic murmurs— not stated in the abstract
Specificity, AS
Systolic murmurs78%
Diastolic murmurs— not stated in the abstract
Specificity
Systolic murmurs— not stated in the abstract
Diastolic murmurs>99%
— not stated in the abstract
- Murmurs detected by GPs
- 487 participants (23%)
- Significant valvular heart disease (VHD) on echocardiography
- 392 participants (19%)
- Significant VHD with audible murmur
- 139 of them (35.5%)
- Specificity of distinct murmurs across all VHD types
- exceeded 94%
Further findings
Factors independently associated with VHD among participants with murmurs
| OR (95% CI) | ||
|---|---|---|
| Age ≥70 years | 2.0 (1.2–3.4) | |
| Male sex | 3.3 (2.0–5.3) | |
| Previous myocardial infarction | 2.3 (1.0–5.2) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Heart murmurs in the general population: diagnostic value and prevalence from the Tromsø Study. Heart. Published 1 August 2025. doi:10.
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