Cardiac murmurs Flashcards
Types of cardiac murmur
Physiological murmur
Endocardial disease
Murmur caused by congenital abnormality
Cardiac rhythm disturbance
Physiological dysrhythmia - 1st/2nd degree AV block and RSA
Pathological dysrhythmia - atrial fibrillation, ectopy
What are things to look for if a horse presents with poor performance/collapse?
Rhythm disturbances
Vascular catastrophe
Where is jugular pulsation visible?
Normally visible in distal third of neck - dependent on head and neck position and obstruction
Oedema on clinical exam
Usually caused by hypoproteinaemia
Pulmonary oedema
§ Left sided cardiac failure
§ Acute left sided heart disease
§ Pulmonary hypertension and cor-pulmonale
Peripheral oedema
§ Right sided cardiac failure
§ Hypoproteinaemia
§ Vascular disease
Congestive heart failure in horses
Left sided heart failure
§ Pulmonary oedema
□ Ruptured chordae tendinae
□ Bacterial endocarditis
□ Congenital cardiac disease
□ Pulmonary hypertension
Right sided heart failure - usually noticed first
§ Peripheral oedema
□ Chronic endocardial disease
Tachycardia
Where do you ausculatate the aortic (and pulmonic) valves? (horse)
LIC 4
Just behind, and under triceps
Pulmonary hypertension in horses
Important risk factor for development of vascular failure
Secondary
§ Mitral valve regurgitation
§ Atrial fibrillation
§ Aortic valve regurgitation
Primary
§ Pulmonary disease
§ Hypoxia, altitude
Where do you ausculatate the mitral valve? (horse)
LIC 5
Just behind the triceps, halfway between the elbow and the shoulder
What pitched sounds can you hear using the diaphragm of a stethoscope?
High pitched
E.g.
- S1 and S2
- Aortic regurgitation
- Mitral regurgitation
- pericardial friction rubs
What pitched sounds can you hear using the bell of a stethoscope?
Medium-low pitched sounds
E.g.
- S3 and S4
- Mitral stenosis
Normal heart sounds in a horse
S4 (shh)
S1 (Lub)
S2 (Dub)
S3 (de)
S4 sound
Onset of atrial systole - audible in 60% of TB
S1 sound
Onset of ventricular systole
Closure of AV valves opening of semilunar valves
Loudest over LIC 5 (hypertension, adrenaline, MVD)
S2 sound
Onset of diastole
Closure of semilunar valves, open AV
Loudest over LIC 4 (fever, adrenaline, anaemia)
