Heart murmur- when to refer for Echocardiogram
A murmur heard during examination nature of the murmur family history age ( especially if > 75 OR medical history (for e.g h/o atrial fibrillation ) Consider an echocardiogram for adults with murmur & no other signs or symptoms if valve disease is suspected based on above.
signs ( such as peripheral oedema ) or symptoms ( as angina and breathlessness ) or an abnormal ECG OR an ejection systolic murmur with a reduced 2nd HS but no other signs or symptoms , Offer an echocardiogram to adults with a murmur if valve disease is suspected (based on the nature of murmur , family history , age or medical history ) + above
systolic murmur and exertional syncope murmur and severe symptoms ( as angina or breathlessness on minimal exertion or at rest ) thought to be related to valvular heart disease . Valvular heard disease is suspected based on the nature of the murmur , family history , age or medical history. Urgent 2 week specialist assessment that includes Echo or if not available an urgent Echo alone.
Reference Heart valve disease presenting in adults: investigation and management NICE guideline [NG208]