Aortic ejection velocity in healthy Boxers with soft cardiac murmurs and Boxers without cardiac murmurs: 201 cases (1997-2001)

OBJECTIVE: To determine aortic ejection velocity in healthy adult Boxers with soft ejection murmurs without overt structural evidence of left ventricular outflow tract obstruction and in healthy Boxers without cardiac murmurs. DESIGN: Retrospective study. ANIMALS: 201 Boxers. PROCEDURE: Dogs were examined independently by 2 individuals for evidence of a cardiac murmur, and a murmur grade was assigned. Maximal instantaneous (peak) aortic ejection velocity was measured by means of continuous-wave Doppler echocardiography from a subcostal location. Forty-eight dogs were reexamined approximately 1 year later. RESULTS: A soft (grade 1, 2, or 3) left-basilar ejection murmur was detected in 113 (56%) dogs. Overall median aortic ejection velocity was 1.91 m/s (range, 1.31 to 4.02 m/s). Dogs with murmurs had significantly higher aortic ejection velocities than did those without murmurs (median, 2.11 and 1.72 m/s, respectively). Auscultation of a murmur was 87% sensitive and 66% specific for the identification of aortic ejection velocity > 2.0 m/s. An ejection murmur and aortic ejection velocity > 2.0 m/s were identified in 73 (36%) dogs. For most dogs, observed changes in murmur grade and aortic ejection velocity during a follow-up examination 1 year later were not clinically important. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that ejection murmurs were common among healthy adult Boxers and that Boxers with murmurs were likely to have high (> 2.0 m/s) aortic ejection velocities. The cause of the murmurs in these dogs is unknown.     

Echocardiographic assessment of the left ventricular outflow tract in the Boxer

BACKGROUND: Soft, variable ejection murmurs are common in Boxers and are associated with increased left ventricular outflow tract (LVOT) ejection velocities. Whether these murmurs are physiologic or indicate mild aortic stenosis is controversial. Ejection velocity is impacted by LVOT area and ventricular stroke volume (SV), suggesting that these variables are pertinent to murmur development. HYPOTHESIS: Boxers with ejection murmurs have a smaller LVOT and equivalent SV indices, compared with values in dogs without murmurs. ANIMALS: Three age- and weight-matched groups of dogs--15 Boxers with soft ejection murmurs (group I); 15 Boxers without murmurs (group II); and 15 nonBoxer dogs without murmurs (group III)--were studied. METHODS: All dogs underwent 2-dimensional and Doppler echocardiographic examinations. The LVOT size at multiple levels; LVOT ejection velocity, stroke distance, and SV index; and right ventricular SV index were determined and compared by analysis of variance. RESULTS: Indexed LVOT areas in Boxer groups were not different, but were significantly smaller than those of non-Boxer dogs. Ejection velocities and stroke distances were significantly different across all groups, with group I having the highest and group III having the lowest values. Doppler SV indices (ml/m2) for group-I versus group-II Boxers were 70 +/- 16(SD) versus 62 +/- 12 for the LVOT (P = .27) and 58 +/- 12 versus 48 +/- 9 for the right ventricle (P = .14). CONCLUSIONS AND CLINICAL IMPORTANCE: These data suggest that a relatively smaller LVOT in Boxers predisposes them to increased ejection velocity and development of murmurs. The contribution of SV to the genesis of these often labile murmurs requires additional study.     

Low intensity heart murmurs in boxer dogs: inter-observer variation and effects of stress testing

Inter-observer variation in the detection and grading of low intensity heart murmurs in boxer dogs was investigated. Six veterinarians with different levels of experience examined 27 boxers by cardiac auscultation. The dogs were auscultated before and after exercise, and the results were compared with phonocardiographic and echocardiographic examinations performed at rest and during two different stress tests. A subvalvular aortic ridge was identified in six dogs on two-dimensional echocardiography. Using dogs with low intensity murmurs or dogs free of heart murmurs, inter-observer agreement was positively correlated to the level of experience at rest (weighted kappa [kappa] 0.14 to 0.75), while the agreement was poor after exercise (weighted kappa 0.01 to 0.36). The presence of a subvalvular aortic ridge was associated with higher aortic flow velocities (P<0.002) and higher auscultatory murmur grading (P<0.001). There was an increase in murmur duration during one kind of stress test (P<0.001) and in aortic flow velocity during the other (P=0.001).     

Prevalence of murmurs consistent with aortic stenosis among boxer dogs in Norway and Sweden

The prevalence and severity of cardiac murmurs consistent with subclinical or clinically detectable aortic stenosis among purebred boxer dogs in Norway and Sweden were evaluated. Two hundred and thirty-one boxers, randomly selected or investigated at dog shows, were examined by phonocardiography by two veterinarians and classified on the basis of the characteristics of their murmurs into categories 0 to 4. No murmur was detected in 23 per cent of the dogs, murmurs classified as category 1 were diagnosed in 25 per cent of the dogs, as category 2 in 46 per cent, as category 3 in 7 per cent cent, and two dogs had category 4 murmurs. In 55 per cent of the dogs, primarily those with very soft murmurs, there was some variation in the intensity of the murmur from beat to beat. The prevalence of cardiac murmurs among Norwegian and Swedish boxers was high and similar to the prevalence reported in Great Britain.     

Cause of heart murmurs in 57 apparently healthy cats

Heart murmurs are caused by turbulent blood flow or by vibration of cardiac structures. Turbulent blood flow may originate from structural heart disease or from physiological phenomena. The aims of this study were to establish the cause of heart murmurs in apparently healthy adult cats and to determine whether a heart murmur is a reliable indicator of heart disease. In this retrospective study, we reviewed the medical records of cats in which a heart murmur was detected during physical examination by one of the authors in the period January 2008 to December 2009. Cats younger than 6 months and those with systemic disease were excluded. Timing, grade, and point of maximum intensity of the murmur were determined by one observer (MD) before 2D-, M-mode and Doppler echocardiography. Fifty-seven cats (median age 76 months, range 6-194) were included, 30 neutered females and 27 neutered males. All murmurs were systolic and varied in intensity from 2/6 to 5/6. The point of maximum intensity was the left or right parasternal region in 34/57 (61%) of murmurs. Murmurs were caused by dynamic left ventricular outflow tract obstruction in 25/57 (44%) cats, dynamic right ventricular outflow tract obstruction in 9/57 (16%) cats, and combined dynamic left and right outflow tract obstruction in 11/57 (19%) cats. In 5 (9%) cats the cause of the murmur could not be identified. Heart disease was present in 50 (88%) cats, namely, left ventricular hypertrophy in 44 (77%) and congenital defects in 6 (11%) cats. In conclusion, most heart murmurs in apparently healthy cats are detected in the left or right parasternal region and are caused by dynamic left and right ventricular outflow tract obstruction. Because most cats (88%) with a heart murmur had heart disease in this study, if a heart murmur is detected in an apparently healthy cat, echocardiography is recommended to determine the cause of the heart murmur and the presence of heart disease.     

Analysis of murmur intensity, duration and frequency components in dogs with aortic stenosis

A study was undertaken to investigate the relationship between murmur intensity, murmur duration, duration to peak intensity and frequency components with degree of aortic stenosis in boxers. Measurements were made from phonocardiograms obtained from 35 boxers with ejection-type murmurs, and values were compared with those obtained for aortic flow velocity measured by Doppler echocardiography. Murmur intensity graded by auscultation was significantly correlated with aortic flow velocity (P<0·001), and murmur duration, expressed as a percentage of systole, was significantly correlated with aortic flow velocity (P<0·001), independent of heart rate. Dogs with early systolic murmurs not exceeding 50 per cent of systole had aortic flow velocities of less than 1·5 m/second and no echocardiographic abnormalities, in contrast with dogs with murmurs of longer duration. Dogs with only high frequency components had lower aortic velocities than those that also had components in the medium frequency range (P<0·01).     

Heart murmurs and valvular regurgitation in thoroughbred racehorses: epidemiology and associations with athletic performance

BACKGROUND: Cardiac murmurs associated with valvular regurgitation occur commonly in conditioned performance horses, but their association with athletic performance is unknown. HYPOTHESIS: Cardiac valvular regurgitation has a negative association with race performance. ANIMALS: Five hundred and twenty-six "race fit" Thoroughbred racehorses engaged in either flat (race distance 1,000-2,500 m) or jump racing (race distance 3,200-6,400 m). METHODS: Cardiac auscultation and color flow Doppler (CFD) echocardiography were performed on 777 occasions. The associations between the presence and severity of either an audible cardiac murmur or valvular regurgitation assessed by CFD, and published, objective measures of race performance were determined using a standard regression approach. RESULTS: The prevalence of murmurs and of regurgitation varied significantly between racetypes (P<.02), generally increasing from 2-year olds to chasers. There were no consistent associations between racing performance and either grade of murmur or regurgitation, whether the presence or absence of regurgitation or murmur, or only murmurs > or =3/6 or regurgitation > or =6/9, were considered. CONCLUSIONS AND CLINICAL IMPORTANCE: There were differences in prevalence and severity of murmurs of atrioventricular and aortic valve regurgitation between racehorses in different disciplines. Data also showed that neither regurgitation nor murmurs were negatively associated with Timeform rating, an index of UK racehorse quality, in any of the groups of racehorses studied.     

A prospective study of systolic ejection murmurs and left ventricular outflow tract in boxers

Objectives : To investigate the prevalence and progression of murmurs and the development of the left ventricular outflow tract (LVOT) and flow velocities in the great arteries in boxer puppies through adolescence until three years of age. Methods : Nineteen boxer puppies with or without a low‐intensity murmur, but without evidence of congenital heart disease, were studied prospectively. Examinations were carried out at 7 weeks, 3, 4, 6, 9, 12 and 36 months of age by cardiac auscultation and Doppler echocardiography. Results : Presence and intensity of heart murmurs varied in the same dog and between dogs, but flow velocities did not change. Estimated effective orifice diameter (EOD) and indexed EOD was significantly narrower than measured subvalvular and valvular diameters. Clinical Significance : The variability in presence and intensity of low‐intensity ejection murmurs is high during growth in boxers.     

Assessment of the prevalence of heart murmurs in overtly healthy cats

OBJECTIVE: To assess the frequency of heart murmurs in overtly healthy cats. DESIGN: Prospective study. SAMPLE POPULATION: 103 healthy domestic cats. PROCEDURE: Background information and physical characteristics were assessed in cats that were candidates for blood donation during an 8-month period. For cats with heart murmurs, additional information collected included murmur timing, grade, point of maximal intensity, and presence of additional heart sounds. RESULTS: Heart murmurs were detected in 22 of the 103 (21%) cats. Echocardiography was performed in 7 of those 22 cats. The echocardiogram was considered normal in 1 cat; in the other 6 cats, diagnoses included hypertrophic cardiomyopathy (interventricular septal hypertrophic form [IVSH]; n = 4), left ventricular concentric hypertrophy with valvular disease (1), and equivocal IVSH (1). Thirteen cats had more than 1 examination during the study; 3 of them developed heart murmurs. There were no significant differences in age, sex, breed, coat color, eye color, or heart rate between cats with and without murmurs. Among the 103 cats, there were 6 pairs of siblings from 6 multiple-cat households and 16 cats from 7 multiple-cat households in which the cats were not related; the proportion of cats with murmurs was higher in the related cats (5/12) than in the unrelated cats (3/16), but the difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that heart murmurs are detectable in a large proportion of overtly healthy cats and that many murmurs appear to be caused by structural heart disease that is in a clinically latent state.     

Dynamic right ventricular outflow obstruction: a new cause of systolic murmurs in cats

We have identified and characterized a new cause of variable parasternal systolic murmurs in cats. Color Doppler echocardiography of 51 cats presented for evaluation of a cardiac murmur demonstrated a localized, turbulent systolic jet located within the right ventricular (RV) outflow region, originating just cranial to the tricuspid valve. Spectral Doppler tracings of the turbulent jets showed abnormally high peak velocity, late systolic flow acceleration, and marked variability with heart rate, typical of dynamic stenosis. Frame-by-frame examination of 2-dimensional (2D) echocardiographic images after color Doppler subtraction revealed systolic apposition of the RV free wall with the interventricular septum at the origin of the turbulent jets. Therefore, we termed this turbulent flow pattern "dynamic right ventricular obstruction" (DRVO). Most cats with DRVO were >4 years old (45 of 51, 88%) and initially presented with concurrent noncardiac disease (73%). Noncardiac diseases associated with DRVO in older cats included high cardiac output states (hyperthyroidism, anemia, and inflammatory disease) and chronic renal failure with and without systemic hypertension. Of the 45 cats >4 years old, 4 (9%) had no evidence of any other cardiac or noncardiac disease. In contrast, 5 of 6 cats (83%) <4 years old had concurrent cardiac disease. No breed predisposition was identified. Follow-up examination of 10 cats demonstrated no change in the disorder in 8 cats but revealed the disappearance of the murmur and abnormal RV Doppler flow signal in 2 cats after renal transplantation. We propose that DRVO is a physiologic cause of systolic murmurs in cats attributable to RV systolic narrowing.     

Innocent Cardiac Murmur in Puppies: Prevalence,Correlation with Hematocrit,and Auscultation Characteristics

Background

The aims of this study were to establish the prevalence of innocent cardiac murmurs in clinically healthy puppies, to investigate a possible correlation between the presence of an innocent murmur and hematocrit, and to describe the auscultation characteristics of innocent murmurs.

Hypothesis

Lower hematocrit contributes to the genesis of innocent murmurs.

Animals

Five hundred and eighty‐four client‐owned clinically healthy puppies, between 20 and 108 days old.

Methods

Two cross‐sectional surveys with a 1‐year (n = 389 pups) pilot and a half‐year (n = 195 pups) principal study periods. Cardiac auscultation was performed by a single, board‐certified cardiologist. Hematocrit was measured with an automatized hematology analyzer. Echocardiography was performed only on puppies with a cardiac murmur in the principal study.

Results

In the pilot study, 15% of the dogs had a murmur. Innocent murmur was diagnosed in 28% of the 195 dogs in the principal study. Innocent murmurs were systolic, mostly with a musical character and with a maximal intensity of 2 of 6, and mostly with the point of maximal intensity in the left cardiac base. The hematocrit was significantly lower in the group with a murmur compared to the group without (P = .023).

Conclusions and Clinical Importance

Innocent murmur was a common finding in puppies at the age when the first veterinary controls usually take place. Physiologic anemia contributes to the genesis of innocent murmurs in puppies. Rising hematocrit in growing puppies can explain the spontaneous disappearance of innocent murmurs with aging. Hematocrit did not differentiate innocent murmurs from abnormal murmurs.     

Auscultation in mild mitral regurgitation in dogs: observer variation, effects of physical maneuvers, and agreement with color Doppler echocardiography and phonocardiography

Observer variation in diagnosing mild mitral regurgitation in dogs by cardiac auscultation was assessed by having 6 veterinarians with different levels of experience examine 57 Cavalier King Charles Spaniels. Comparisons with color Doppler echocardiography and phonocardiography were made, and the effects of 2 physical maneuvers on the auscultatory findings were evaluated. Using mildly diseased dogs, interobserver agreement in diagnosing the presence or absence of left-sided murmurs ranged from 63% to 88%. The agreement with phonocardiography (range, 53-91%) increased with the amount of observer experience. The 2 most experienced observers could discern soft ejection murmurs from regurgitant murmurs and were able to diagnose 89% of the dogs with regurgitant jets larger than 30% of the left atrial area. In general, less experienced observers diagnosed most jets larger than 50%. In many dogs with small jets, no murmur was found by auscultation and phonocardiography. The audibility of mild regurgitation was significantly reduced in dogs that were difficult to auscultate. Early systolic murmurs were typical of mild regurgitation, whereas holosystolic murmurs typified severe regurgitation. In a few dogs, late systolic murmurs alternated with holosystolic murmurs. Systolic clicks were found phonocardiographically in 18 dogs with mild to moderate regurgitation, but the audibility apparently was low. In many mildly affected dogs, physical maneuvers increased murmur intensity. Thus, some form of dynamic auscultation might facilitate the diagnosis of mild regurgitation. Auscultatory findings in mild regurgitation appear to depend on observer experience, circulatory status, and how difficult the dog is to auscultate.     

Congenital heart diseases in the boxer dog: A retrospective study of 105 cases (1998-2005)

Subaortic stenosis (SAS) is one of the most common congenital heart diseases (CHD) in dogs with Boxers being predominantly affected. However, the increasing availability of modern diagnostic imaging systems now allows a better assessment of cardiac morphology and function, thereby facilitating early detection of CHD in awake animals. In this context, the case records of Boxer dogs diagnosed with CHD using echocardiography combined with Doppler mode, were retrospectively reviewed (1998-2005). One hundred and five Boxers exhibiting either a single CHD (53/105, 50.5%) or association of several CHD (52/105, 49.5%) were included. The most common CHD was atrial septal defect (ASD) observed in 56.2% of these animals (59/105), followed by mitral dysplasia (58/105, 55.2%), and SAS (49/105, 46.7%). SAS was associated with one or two CHD in 29.5% of cases (31/105). Most of the dogs with a low intensity left heart base systolic murmur had an isolated ASD whereas most of the dogs with a similar but high intensity murmur had SAS, either isolated or associated with a concurrent CHD. The incidence of ASD and mitral dysplasia in Boxer dogs is higher than previously assumed, and ASD is a common cause of left heart base systolic murmur in this breed of dog. This confirms that the detection of such a murmur should not be used as the unique criterion for diagnostic confirmation of SAS.     

Sound recording and digital phonocardiography of cardiac murmurs in dogs by using a sensor-based electronic stethoscope

The goals of this study were to present a technique of digitalised sound recordings and phonocardiograms (dPCGs), and to analyse its diagnostic capabilities. Heart sounds of 20 dogs were auscultated in vivo (on-line) and recorded with dPCGs by two authors using a Welch Allyn Meditron Stethoscope System. Sound recordings were auscultated off-line and blindly by four different observers having various auscultatory experiences, then listened to while viewing dPCGs. The results were compared to echocardiographic diagnoses. There was a significant agreement (p < 0.001) between on-line and off-line auscultatory findings regarding the four observers, ranging from 45% to 75% (weighted kappa values: 0.72 to 0.87). The best agreement was achieved by Observer 1 having the highest experience. Significant differences (p < 0.05) were found between Observer 1 and Observer 4 (with the lowest experience) in judging the quality of the murmurs during the off-line and blind auscultation. However, there were only minimal differences (95% to 100% agreements) in dPCG analyses among the four observers regarding intensity and quality of the murmurs while simultaneously listening to and viewing the dPCGs. Significant correlations were found between the traditional '0 to 6 scale' and a new '0 to 3 scale' murmur intensity gradings by all observers (correlation coefficients 0.640 to 0.908; p < 0.01 to p < 0.001). Analysis of dPCGs might be a valuable, additional tool helping with the diagnosis of canine cardiac murmurs, especially for those with less cardiological experience.     

TRANSESOPHAGEAL ECHOCARDIOGRAPHY OF THE LEFT VENTRICULAR OUTFLOW TRACT, AORTIC VALVE AND ASCENDING AORTA IN BOXER DOGS WITH HEART MURMURS

The study was aimed at evaluating the anatomy of the left ventricular outflow tract, aortic valve, and ascending aorta by means of multiplane transesophageal echocardiography in Boxer dogs with left basilar heart murmurs and at comparing two-dimensional (2D) transthoracic to transesophageal echocardiography for the diagnosis of subaortic stenosis in this breed. Twenty-eight Boxers were included in the study and allocated to four groups according to physical and routine transthoracic 2D and Doppler echocardiography findings: group A--dogs with low grade (I-II/VI) heart murmurs without overt evidence of aortic stenosis (14 dogs); group B--dogs with type 1 subaortic stenosis (seven dogs); group C--dogs with type 2 subaortic stenosis (five dogs); group D--dogs with type 3 subaortic stenosis (two dogs). Anatomic lesions were not discovered by transesophageal echocardiography in dogs belonging to group A. Transesophageal imaging confirmed the type of subaortic stenosis, as graded by transthoracic echocardiography, in diseased animals (groups BCD). Morphologic information obtained by transesophageal echocardiography in Boxer dogs was similar to that obtained by transthoracic echocardiography.     

Left basilar systolic murmur in retired racing greyhounds

Nineteen of 28 (67%) Greyhounds enrolled in the Blood Donor Program at The Veterinary Teaching Hospital, The Ohio State University (Columbus, OH), had a left basilar systolic murmur. Ten Greyhounds with murmurs and 9 without murmurs were evaluated to gain knowledge about the pathogenesis of this murmur. Echocardiograms were performed without sedation by means of a GE Vivid 7 Echocardiographic System with a continuous ECG; systolic arterial blood pressure (SABP) was measured with an Ultrasonic Doppler Flow detector model 811-B. The mean peak aortic velocity in the Greyhounds with murmurs (2.15 m/s; range, 1.8-2.2 m/s) was significantly higher than in the Greyhounds without murmurs (1.89 m/s; range, 1.6-2.0 m/s) (P < .001); there were no significant differences between groups for aortic valve or annulus diameter, fractional shortening, pulmonic velocity, SABP, hematocrit, serum protein concentration, or red blood cell counts. In this study, Greyhounds with soft, left basilar systolic murmurs had mildly (but significantly) higher mean peak aortic velocities than similar dogs without murmurs. In the dogs with murmurs (and higher velocities), we could not identify structural abnormalities, such as valvular lesions or other congenital defects. There was no inverse correlation between the systolic murmur and the higher hematocrit and red blood cell counts observed in this breed. This 1-2/6 basilar systolic murmur is common in Greyhounds, and it does not appear to be of any clinical consequence.     

Effect of age and training on murmurs of atrioventricular valvular regurgitation in young thoroughbreds

Cardiac auscultation was carried out on 111 Thoroughbred horses age 2-5 years to test the hypothesis that athletic training might influence the development of atrioventricular (AV) valve regurgitation in young Thoroughbreds. Murmurs of valvular regurgitation were identified and graded on a 1-6 scale. There were 2 sources of auscultation data: 1) 55 2-year-old horses that were examined by auscultation before training commenced and 9 months later when at race fitness; 2) 56 horses age 2-5 years that were examined on one occasion only (25 2-year-olds, 23 3-year-olds, five 4-year-olds and five 5-year olds). All horses in the second data set were in full training and racing regularly at the time of the examination. To conclude the study, 35 horses were selected randomly from both groups of horses and examined with colour-flow Doppler echocardiography. The aim of the final part of the study was to check specificity and sensitivity of auscultation for detection of AV valve murmurs and therefore validate the auscultation findings. Prior to training, the prevalence in 2-year-old racehorses of murmurs of mitral regurgitation and tricuspid regurgitation was 7.3% (4/55) and 12.7% (7/55), respectively. After training, the prevalence proportions increased to 21.8% (12/55) and 25.5% (14/55). After training, one horse developed a murmur characteristic of aortic regurgitation. The differences in murmur prevalence were statistically significant for mitral and tricuspid regurgitation (paired t test results: mitral regurgitation, P = 0.019; tricuspid regurgitation, P = 0.007), as were the differences in mean murmur grade (P = 0.018 and P = 0.0006, respectively). There were no significant effects of age on the prevalence of valvular regurgitation in 56 horses examined at race fitness. Auscultation was a specific (specificity 100%) and reasonably sensitive method for detection of murmurs of mitral and tricuspid regurgitation (mitral regurgitation: positive predictive value 100%, negative predictive value 84%, tricuspid regurgitation: positive predictive value 100%, negative predictive value 65%). These data suggest that the prevalence and grade of murmurs of mitral and tricuspid valvular regurgitation increase in 2-year-old Thoroughbreds after 9 months of athletic training. Whereas the effects of age and growth on the prevalence of murmurs cannot be ruled out from these data, this study suggests that there is an influence of athletic training on the development of atrioventricular valvular regurgitation in flat-racing Thoroughbreds.     

Prevalence and clinical importance of heart murmurs in racehorses

OBJECTIVE: To determine the prevalence of various types of heart murmurs in Thoroughbred racehorses and assess their association with performance by echocardiography and review of the horses' race records for the preceding 2 years. DESIGN: Clinical and retrospective study. ANIMALS: 846 Thoroughbred racehorses. PROCEDURE: Cardiac auscultations were performed by 3 individuals; for 30 horses, Doppler echocardiographic examinations were also performed. Statistical analyses of race records for 753 horses were performed to assess association of heart murmurs with performance. RESULTS: Heart murmurs were detected by cardiac auscultation in 686 of 846 (81.1%) horses. Systolic murmurs over the heart base were most common; 365 (43.1%) horses had systolic murmurs that were loudest over the pulmonary valve area, and 232 (27.4%) horses had systolic murmurs that were loudest over the aortic valve area. Systolic murmurs over the tricuspid valve area were detected in 241 (28.5%) horses, whereas systolic murmurs over the mitral valve area were detected in only 32 (3.8%) horses. Diastolic murmurs were much less common than systolic murmurs. Review of race records did not reveal a significant association between murmurs and performance. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that heart murmurs are a common finding in racehorses; most of these heart murmurs do not appear to be clinically important.     

Abnormal heart sounds and murmurs of the dog

Abstract— —In addition to physiological murmurs as found in association with fever and anemia, a number of organic murmurs resulting from cardiac lesions frequently occur in dogs. These include the pansystolic regurgitant murmur of mitral and tricuspid insufficiency and interventricular septal defect, the ejection systolic murmur of aortic and pulmonic stenosis and the continuous murmur of patent ductus arteriosus. The arterial diastolic murmur of aortic insufficiency occurs less frequently; that of pulmonic insufficiency is even less often encountered. The passive atrioventricular diastolic murmurs and atriosystolic murmurs of relative or absolute mitral or tricuspid stenosis are extremely rare. The most frequently heard abnormal transients in the dog are the ventricular diastolic gallop, the systolic click, and the presystolic atrial gallop. Splitting of the second heart sound is a fairly common finding in areas where heartworm heart disease is prevalent. Paradoxical splitting of S₂ is only occasionally observed. Résumé— —En surcoit des souffles physiologiques comme constatés en association à la fiévre et l'anémie, de nombreux souffles organiques résultant de lésions cardiaquessurvenant fréquemment chez le chien. Ceux-ci comprennent le souffle pansystolique régurgitant d'insuffisance mitrale et tricuspide et de défaut de la cloison interventriculaire, le souffle d'éjection systolique de retricissement aortique et pulmonaire et le souffle continuel patent du canal arteriosus. Le souffle arteriel diastolique de l'insuffisance aortique se présente moins fréquemment; celui de l'insuffisance pulmonaire survient encour moins souvent. Les souffles passifs atrioventriculaires diastoliques et les souffles atriosystoliques de retrecissement relatifs ou obsolus mitral ou tricuspide sont extrêmement rares. Les transitions anormalies les plus souvent survenues chez le chien sont le galop ventriculaire diastolique, le clic systolique, et le galop artériel presystolique. La séparation du son du second coeur et assez commune dans les régions ou les maladies cardiaques prévalent. La séparation paradoxale de S est occasionnellement observée. Zusammenfassung— —Ausser physiologischen Geraeuschen in Verbindung mit Fieber und Anaemic treten eine Anzahl von organischen Geraeuschen als Resultat von Herzstoerungen haeufig bei Hunden auf. Diese umfassen das pansystolische rueckfliessende Geraeusch der mitralen und trik-uspidalen Insuffizienz und des interventrikularen Septum-Defekts, das Ejektions-systolische Geraeusch der Aorten- und Pulmonal-Stenose und das Dauer-Geraeusch des offenen Duktus arteriosus. Das arterielle diastolische Geraeusch der Aorten-Insuffizienz tritt weniger haeufig auf, das der Pulmonal-Insuffizienz noch seltener. Die passiven atrioventrikulaeren diastolischen Geraeusche und atrio-systolischen Geraeusche der relativen oder absoluten mitralen oder trikuspidalen Stenose sind ausserordentlich selten. Die am haeufigsten gehoerten anormalen vorueber-gehenden Geraeusche beim Hund sind der ventrikulaere diastolische Galopp-Rhythmus, das systolische Einschnappen und der praesystolische atriale Galopp-Rhythmus. Spaltung des zweiten Herztones ist eine ziemlich haeufiger Befund in Gegenden, wo die Herzwurm-Krankheit haeufig ist. Paradoxe Spaltung des zweiten Tones wird nur gelegentlich beobachtet.