Clinical relevance of musical murmurs in color-coded duplex sonography of peripheral and visceral vessels

C. Thalhammer, M. Aschwanden, M. Husmann, C. Jeanneret, V. Jacomella, R. K.J. Clemens, K. Stock, B. R. Amann-Vesti

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Musical murmurs (MMs) are Doppler phenomena which sound like high-frequency musical sounds. They refl ect high and turbulent fl ow within relevant stenoses and were fi rst described in degenerated bioprosthetic valves and later in intracranial vessels and were associated either with high-grade arterial stenosis, small collateral arteries or carotid cavernous fi stulas. Objective of this article is to illustrate the spectrum of imaging of MMs observed in renal, intestinal and peripheral vessels. Patients and methods: Four experienced vascular ultrasound laboratories had been asked to report their cases with documented musical tones in color coded duplex sonography (CCDS) within a two year observational period (2008 and 2009). Documented Doppler fi ndings and corresponding clinical data were analyzed. Results: MMs were found in 18 patients with an incidence of 0.05% and were observed in high grade stenosis in hemodialysis access (n = 5), in post-biopsy arteriovenous fi stulas after renal transplantation (n = 3), in renal transplant artery (n = 1) and vein (n = 3), stenoses in peripheral (n = 2) and intestinal arterial disease (n = 2), and in peripheral veins (n = 2). Conclusions: The so called musical murmurs are a rare but potentially relevant fi nding in CCDS. They are caused by a variety of underlying pathologies with different clinical implications, however correct interpretation is mandatory since urgent therapy might be necessary.

Translated title of the contributionKlinische relevanz von musikalischen geräuschen in der farbkodierten duplexsonographie von peripheren und viszeralen gefässen
Original languageEnglish
Pages (from-to)302-307
Number of pages6
JournalVasa - European Journal of Vascular Medicine
Issue number4
StatePublished - 2011
Externally publishedYes


  • Doppler ultrasound
  • Duplex ultrasound
  • Musical murmurs
  • Peripheral artery
  • Visceral artery


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