Ivcd cardiac murmurs9/19/2023 ![]() Place palms over the left and right thorax to identify if a thrill is present.Ģ. As such, heart murmurs in cats are generally described as being located on the left or right parasternum or sternum.Ĭardiac Auscultation Technique in Dogs and Catsġ. Moreover, the small feline heart makes isolation of a murmur to the apex or base challenging even for those cats with fixed anatomical defects. The mechanism by which these murmurs are generated precludes their localization at the base or apex. Describing a murmur more specifically as "pulmonic" or "aortic" based on identification of a left basilar murmur assumes a degree of accuracy that is unreasonable given the intimate proximity of these anatomical sites.įor cats, the majority of systolic murmurs are attributable to dynamic right ventricular outflow tract obstruction (DROVOTO) or systolic anterior motion (SAM) of the mitral valve with hypertrophic cardiomyopathy (HCM). The right apex is the region of the tricuspid valve. The left base is the region of the pulmonic and aortic valves. The left apex is directly over the region of the mitral valve. The point of maximal intensity of the murmur is described as left or right, apical or basilar. In dogs and cats, isolated diastolic murmurs are very rare. Murmurs may also be described as continuous that is, a murmur is continuously present throughout the cardiac cycle. A diastolic murmur is heard during ventricular diastole that is, immediately after S2. Moderate murmur immediately audible with auscultationĪudible with stethoscope held slightly off chest wallĪ systolic murmur is one that is heard during ventricular systole that is, between the first (S1) and second (S2) heart sounds. Soft murmur that is audible with careful auscultation ![]() Very soft murmur that is not immediately audible but can be heard only after careful auscultation in a quiet environment For example, a dynamic grade I–III/VI murmur describes a murmur that has an intensity that varies throughout the auscultation period, from difficult to hear (grade I) to immediately identifiable (grade III). 1 If murmur grade varies, as it often does in cats, the term "dynamic" is used and the grade is given as a range. Murmur intensity or "grade" is defined below. Intensity refers to the loudness of a murmur. When attributable to cardiac disease, murmur characteristics reflect which underlying cardiac disease may be present.ġ. Accurate description of a heart murmur facilitates determination of its possible genesis, whether it be physiologic or attributable to cardiac disease. Heart murmurs are routinely described by 1) intensity (loudness) 2) timing in the cardiac cycle and 3) location. In some cases, turbulent blood flow not only produces a heart murmur, but also a thrill that is palpable on the chest wall. When heart disease produces a heart murmur, it is because dynamic or fixed pathology disturbs laminar blood flow and creates turbulence. 1 In a normal heart, blood flow is characteristically laminar and hence silent. Third and fourth heart sounds should not be appreciated in a normal dog or cat.Ī heart murmur is defined as a prolonged series of auditory vibrations emanating from the heart or blood vessels, most commonly attributable to turbulent blood flow. The second heart sound (S2) is audible at the completion of ventricular systole and is attributable to closure of the aortic and pulmonic valves. ![]() The first heart sound (S1) is attributable to closure of the mitral and tricuspid valves at the onset of systole. In a normal dog or cat, two heart sounds are audible. Physical examination of the cat or dog with suspected heart disease provides valuable information that allows "short-listing" of differential diagnoses to facilitate appropriate diagnostic and treatment recommendations. ![]()
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