Since the introduction of echocardiography into clinical practice in the 1960s, there has been a marked increase in its utilization, with a sixfold increase in utilization noted in a population-based study during the past decade. Doppler echocardiography has also markedly increased since its introduction in the early 1980s and its routine clinical use since the mid-1980s, which has resulted in a marked increase over time in labeling of patients with regurgitant valvular lesions. The diagnostic labeling associated with this evolving technology may have a major clinical impact. For example, a very strong association between Doppler-detected mitral regurgitation and the provision of endocarditis prophylaxis recommendations in both patients with normal two-dimensional (2D) echocardiograms and those with mitral valve prolapse has recently been demonstrated.
Although studies have evaluated the spectrum of Doppler-detected valvular regurgitation in patients with structurally “normal” hearts, these prior studies utilized pulsed-wave, continuous-wave, or color-flow Doppler techniques but did not combine the technology from all of these modalities, as is routinely done in clinical practice. Therefore, we retrospectively reviewed Doppler echocardiograms from 206 consecutive patients with completely normal 2D echocardiograms in order to determine the presence and severity of valvular regurgitation, particularly of mitral, tricuspid, and aortic valves, and estimated right-sided cardiac pressures in patients with “normal” hearts.