Page 2733 - Cote clinical veterinary advisor dogs and cats 4th

1422 Heart Murmur: Incidental Finding (“Asymptomatic”)

Heart Murmur: Incidental Finding (“Asymptomatic”)
VetBooks.ir Incidentally detected heart murmur

Is murmur diastolic? Is murmur continuous?
Yes Not sure
No:
murmur is systolic
Always abnormal
Evaluate with: Noncardiac explanation for murmur?
• Thoracic radiographs • Anemia (PCV 25%)
• Echocardiogram • Pregnancy
• Fever
• Youth ( 16 weeks of age)*
Yes
No
Reassess after
resolution of condition Historic or physical exam findings possibly
suggestive of decompensated heart disease?
(Any: dyspnea, pulmonary crackles, cough,
abdominal distention, muffled lung or heart sounds,
jugular distention, exercise intolerance, etc.)
Yes
*Murmur of healthy youths No
is always soft ( III/VI), systolic,
and may decrease in intensity with Is patient 2 years old or Yes or not sure Evaluate patient with
:
change in body position or has murmur been present • Thoracic radiographs
increase in heart rate. Murmur should since age 2 years old? • Echocardiogram
generally be gone by age 16 weeks.
No
Decide on diagnostic testing based on murmur location, patient characteristics, owner wishes, and particulars of case

Diagnostic evaluation (thoracic radiographs, echocardiogram) Watchful waiting (no diagnostic testing)
• Always plausible (objective information, noninvasive) • Advantages:
• Advantages: Free
Confirmation of suspected diagnosis Convenient
Identification of unsuspected diagnosis • Disadvantages:
Objective assessment of severity, secondary changes Diagnosis unconfirmed or open
• Disadvantage: Deterioration/permanent changes possible if
Cost and referral may not be feasible reversible lesion remains undiagnosed and
untreated

• Instructions to owners regarding signs of CHF
• Recheck in 3 to 6 months, sooner if overt clinical
signs occur
CHF, Congestive heart failure; PCV, packed cell volume.

AUTHOR & EDITOR: Etienne Côté, DVM, DACVIM

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