The aortic systolic murmur developing with increasing age.

For a number of years increasing attention has been paid to the evaluation of systolic murmurs (White, 1927; Fahr, 1930; Bass et al., 1933; Shapiro, 1939; White et al., 1942; Baker et al., 1943; Levy et al., 1943; Sodeman, 1944; and Master, 1948). It has been found that they are common in patients without evidence of cardiac disease, and the importance of considering factors other than organic valvular stenosis and regurgitation has been stressed (Levine, 1933; Freeman and Levine, 1933; Friedlander and Brown, 1935; Stewart, 1951). Phonocardiographic studies have helped to identify those due to aortic stenosis (Evans, 1947; Leatham, 1951; Mannheimer, 1955; Aravanis and Luisada, 1957; and Wells, 1957). While clinicians are well aware of the high incidence of systolic murmurs in persons past middle age, only a few studies have been devoted to them. A number of investigators have appreciated that the aortic valvular deformities, sometimes responsible for these murmurs, were not necessarily due to rheumatic valvulitis (Broadbent and Broadbent, 1897; Dumas et al., 1927; Friedberg and Sohval, 1939; Rednick, 1942; Evans, 1947). Others have emphasized the role of infundibular narrowing in the genesis of these murmurs (Gallavardin, 1924; Giraud and Bert, 1936). The purpose of this paper is to give the incidence of aortic systolic murmurs, found in a hospital population aged 50 and over, and to analyse the clinical and pathological findings in such subjects.