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VET433: Cardio/Respiratory > Cardiac Auscultation & Murmurs > Flashcards

Cardiac Auscultation & Murmurs Flashcards

1
Q

what side of the stethoscope is used to hear LOW pitched sounds

A

bell

s3, s4, gallop sounds

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2
Q

what side of the stethoscope is used to hear HIGH pitched sounds

A

diaphragm

murmurs, lung sounds

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3
Q

what position is best for cardiac auscultation

A

above and behind the patient while patient is standing

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4
Q

where is the precordium

A

left apex

PMI - point of maximal intensity - area where the heart beat is the loudest/strongest

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5
Q

where should you listen on a dog

A

left apical
left basilar
right apical

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6
Q

where should you listen on a cat

A

left caudal parasternal
right caudal parasternal
left cranial

listen more caudally and sternally than in dogs

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7
Q

what valves are involved in left apical murmurs

A

mitral

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8
Q

what valves are involved in left basilar murmurs

A

pulmonic
aortic

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9
Q

what valves are involved in right apical murmurs

A

tricuspid

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10
Q

what is the S1 heart sound

A

NORMAL - av valves closing

mitral and tricuspid CLOSE

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11
Q

what is the S2 heart sound

A

normal - SL valves closing

aortic and pulmonary CLOSE

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12
Q

what is the S3 heart sound

A

abnormal in SA

passive filling during early diastole

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13
Q

what is the S4 heart sound

A

abnormal in SA

active filling “atrial kick” in late diastole

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14
Q

diagnostic value of heart murmurs in dogs vs cats

A

dogs - almost ALL heart disease dogs have a murmur

cats - cats with heart disease may or may not have a murmur
- murmurs VERY common but often physiologic; not a good indicator of heart disease

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15
Q

physiologic murmur

A

murmurs caused by: bradycardia, anemia, fever, increased sympathetic tone, vasodilation, hyperthyroid, age

young kittens/puppies - > 4-6 months

typically grade II-III

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16
Q

systolic murmurs

A

murmur occurs between S1 and S2 sounds

“sh sh sh sh sh”
may or may not hear the lub dub sounds

systole: AV valves should be closed, SL valves should be open

17
Q

diastolic murmurs

A

murmur occurs between S2 and S1 sounds

“dub shhh dub shhh”
lower pitched grumbling sounds

diastole: AV valves should be open, SL valves should be closed

18
Q

ddx for left apical systolic murmurs

A

mitral regurgitation
1. MMVD
2. DCM
3. endocarditis
4. mitral valve dysplasia

19
Q

ddx for left apical diastolic murmurs

A

mitral stenosis

20
Q

ddx for left basilar systolic murmurs

A

aortic stenosis
pulmonic stenosis
aortic septal defect (ASD)

21
Q

ddx for left basilar diastolic murmur

A

SL valve endocarditis
SL valve regurgitation

22
Q

ddx for right apical systolic murmurs

A

tricuspid regurgitation
ventricular septal defect (VSD)

23
Q

ddx for right apical diastolic murmurs

A

tricuspid stenosis

24
Q

ddx for continuous murmurs

A

PDA (patent ductus arteriosus)

25
Q

grade I murmur

A

soft
one sided
NOT readily apparent

26
Q

grade II murmur

A

soft
one sided
readily apparent

27
Q

grade III murmur

A

moderate intensity
one sided
+/- radiates from apex to base

28
Q

grade IV murmur

A

very loud
both sides of chest
radiates apex to base
NO palpable thrill

29
Q

grade V murmur

A

very loud
both sides of chest
radiates apex to base
HAS palpable thrill

30
Q

grade VI murmur

A

murmur is audible without a stethoscope

31
Q

gallop sounds

A

low pitched, diastolic extra heart sounds (S3, S4)

better indicator of heart disease in cats than murmurs

32
Q

S3 gallop sound

A

early diastole - indicates increased left ventricular end-diastolic pressure

“lub dub thud”

ddx: DCM, heart failure

33
Q

S4 gallop sound

A

late diastole - indicates diastolic dysfunction

“bub lub dub”

ddx: concentric ventricular hypertrophy, old age

VET433: Cardio/Respiratory (17 decks)

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