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    Heart Murmurs in Dogs

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    Canine Heart murmurs algorithm

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    Heart Murmurs in Dogs

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    bulletstorm1173
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    Canine Heart murmurs algorithm

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    Canine Heart murmurs algorithm

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4 views2 pages

    Heart Murmurs in Dogs

    Uploaded by

    bulletstorm1173
    Canine Heart murmurs algorithm

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    HEART MURMURS IN DOGS

    Brian A. Scansen, DVM, MS, DACVIM (Cardiology)


    Ohio State University*

    DOG WITH HEART MURMUR

    Young or never previously auscultated

    Systolic Diastolic Continuous

    Left apex Left base Right

    Mitral valve Subaortic Tricuspid valve


    dysplasia or stenosis or dysplasia or  iastolic murmurs are
    D Patent ductus
    regurgitation pulmonary regurgitation; uncommon arteriosus is most likely
    stenosis or ventricular septal h C onsiderations include h E
     chocardiography is
    functional defect aortic or pulmonary valve helpful to confirm
    murmur or insufficiency; mitral or
    atypical VSD tricuspid stenoses are
    even rarer
    h C onfirm with
    echocardiography

    In general, if the murmur Soft (grade I-II/VI),


    is grade III/VI or higher, ejection-type murmurs
    semilunar valve stenosis is at the left base may be
    likely functional or represent
    h I t is helpful to evaluate mild semilunar valve
    pulse quality, as the pulse stenosis
    in severe subaortic stenosis
    is weak; it is normal in pul-
    monary stenosis or func-
    tional murmurs
    h C  onfirm with
    echocardiography
    DIAGNOSTICS
    Diagnostic tests to help separate these differentials
    include radiography, ECG, or echocardiography
    h E
     chocardiography is most likely to provide a definitive
    diagnosis for congenital heart disease; radiography or
    ECG can be supportive

    *Byline reflects author affiliation on


    original publication. On publication
    of this collection, the author’s
    VSD = ventricular septal defect current affiliation is Colorado State
    University.

    16 cliniciansbrief.com
    DIAGNOSTIC/MANAGEMENT TREE h CARDIOLOGY h PEER REVIEWED

    Middle aged and older

    <15 kg >15 kg Any size with


    fever, lameness,
    new murmur

    Systolic Diastolic Systolic Diastolic


    DIAGNOSIS
    Consider
    endocarditis as a
    differential;
     ortic insufficiency or
    A  ortic insufficiency or
    A
    echocardiography
    pulmonary insufficiency pulmonary insufficiency
    required to confirm
    most likely most likely
    h C auses are rare; h C auses are rare;
    infectious endocarditis, infectious endocarditis,
    congenital malforma- congenital malforma-
    tion, or severe degenera- tion, or severe degenera-
    tion are considerations tion are considerations

    Left base Left apex Right Left base Left apex Right

    If grade III/VI or Mitral valve Tricuspid regurgita- If grade III/VI or Dilated cardiomyop- Tricuspid regurgitation is
    less and with no degeneration (eg, tion is the most likely less and with no athy or mitral valve the most likely differential
    clinical signs, a endocardiosis) differential clinical signs, a degeneration h C onsider degenerative

    functional murmur is the most likely h C onsider degener- functional mur- (eg, endocardiosis) tricuspid valve disease
    is possible differential ative tricuspid mur is possible are both possible and/or pulmonary
    h F or any grade, h T horacic radio- valve disease (eg, h F or any grade, h C onsider echo- hypertension
    consider undiag- graphy or echo- endocardiosis) consider undi- cardiography to h A heartworm antigen

    nosed congeni- cardiography and/or pulmonary agnosed con- differentiate test should be evaluated
    tal heart disease can help evalu- hypertension genital heart h T horacic radio- h C onsider previously
    h A heartworm anti-
    such as subaor- ate overall disease such graphs may also undiagnosed VSD if
    gen test should be
    tic or pulmonary heart size and as subaortic or be pursued to a left basilar systolic
    evaluated
    stenosis or VSD evidence of h C onsider previ-
    pulmonary ste- evaluate overall murmur is also present
    h C onfirm with congestive nosis or VSD heart size and h C onfirm with
    ously undiagnosed
    echocardio- heart failure VSD if a left basilar
    h C onfirm with any evidence of echocardiography
    graphy h C onfirm with
    systolic murmur is echocardio- congestion
    echocardio- also present graphy
    graphy h C onfirm with

    echocardiography

    cliniciansbrief.com 17

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