[May heart murmurs be assessed by telemedicine?]

Tidsskr Nor Laegeforen. 2003 Nov 6;123(21):3021-3.
[Article in Norwegian]


Background: Children often have heart murmurs; referral to a specialist is common. A service for remote auscultation of heart murmurs was established in which heart sounds and short texts were sent as attachment to e-mails. Our aim was to assess the quality of this method.

Material and methods: Heart sounds from 47 patients with no murmur (n = 7), innocent murmurs (n = 20), or with pathological murmurs (n = 20) were recorded using a sensor-based stethoscope and e-mailed to a computer. The sounds were repeated giving 100 cases, randomly distributed on a CD. Four specialists categorised the cases as having "no murmur", "innocent murmur", or "pathological murmur", recorded assessment time, degree of certainty, and need for referral.

Results: On average 2.1 minutes were spent on each case. Mean sensitivity and specificity were 90% and 98%, respectively. Inter- and intra-observer variability were low (kappa 0.81 and 0.87). 93% of cases with a pathological murmur and 13% with an innocent murmur were recommended for referral.

Interpretation: Telemedical referral of children with heart murmurs to a cardiologist is safe, reduces travelling, and saves time. Skilled auscultation is adequate to detect those with innocent murmurs.

Publication types

  • English Abstract

MeSH terms

  • Electronic Mail
  • Electronics, Medical
  • Heart Auscultation / methods*
  • Heart Murmurs / diagnosis*
  • Heart Sounds*
  • Humans
  • Remote Consultation / methods
  • Stethoscopes
  • Telemedicine / methods*