The Murmur of Dynamic Subortic Stenosis Recognition Through A Novel Graphic Display

Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectral pattern, manifesting a sharp and high frequency peak occurring late in systole, often bearing a striking resemblance to the subaortic Doppler flow pattern. Methods: Murmurs found in thirty one subjects with dynamic subaortic stenosis were analyzed after having been recorded with a novel portable device capable of spectral and waveform sound displays. Results: All subjects manifested characteristic frequency patterns, consisting of high and sharp peaks occurring in late systole. With significant subaortic stenosis (resting subaortic flow velocity > 2 m/sec) this pattern was evident at rest. In the presence of little or no resting subaortic obstruction (<2 m/sec) this pattern was produced regularly by the Valsalva maneuver. Conclusions: Dynamic subaortic stenosis produces a specific sound spectral pattern that may provide a basis for clinical evaluation, especially in early detection of this disorder and in screening situations.