Equine Cardiac Murmurs

Question 1

S1 is the __ closure, S2 is the __ closure, S3 is the __ filling and S4 is the __ filling

Answer 1

S1 is the AV valve closure, S2 is the semi lunar valve closure, S3 is the ventricular filling and S4 is the atrial contribution to filling

Question 2

Innocent murmurs are systolic or diastolic and a grade __ or less in intensity occurring in the __of cardiac disease

Answer 2

Innocent murmurs are systolic or diastolic and a grade 3 or less in intensity occurring in the absence of cardiac disease

Question 3

Systolic murmurs have regurgitate flow through the __ valve while diastolic have regurgitant flow through the __ valves.

Answer 3

Systolic murmurs have regurgitate flow through the AV valve while diastolic have regurgitant flow through the semilunar valves.

Question 4

Systolic murmurs (mitral and tricuspid) occur in the __ part of the cardiac cycle while diastolic murmurs (aortic) occur in the __ part of the cycle

Answer 4

Systolic murmurs (mitral and tricuspid) occur in the shorter part of the cardiac cycle while diastolic murmurs (aortic) occur in the longer part of the cycle

Question 5

Harsh murmur

Answer 5

Mitral valve deficiency

Question 6

Musical murmur

Answer 6

Aortic regurgitation

Question 7

honking murmur

Answer 7

Chordae tendinae rupture

Question 8

Mitral regurgitation is a __ L sided __ murmur that is the most common cause of __ in horses. What are some complications that may happen overtime?

Answer 8

Mitral regurgitation is a common L sided systolic murmur that is the most common cause of CHF in horses.

Progressive left atrial enlargement may result in the development of a fib while left ventricular enlargement may result in ventricular ectopy and sudden cardiac death.

Question 9

Aortic regurgitation is a __ sided __ murmur that is musical and a __ sound. Moderate to severe cases may result in cardiac __, AF, ventricular ectopy, or SCD. It commonly occurs as a result of __ related valve degeneration or prolapse

Answer 9

Aortic regurgitation is a left sided diastolic murmur that is musical and a divebombing sound. Moderate to severe cases may result in cardiac enlargement, AF, ventricular ectopy, or SCD. It commonly occurs as a result of age related valve degeneration or prolapse

Question 10

Tricuspid regurgitation is a __ sided __ murmur that is common in equine athletes that may occur secondary to __ and __ disease or develop __ secondary to septic jugular thrombophlebitis

Answer 10

Tricuspid regurgitation is a right sided systolic murmur that is common in equine athletes that may occur secondary to pulmonary hypertension and interstitial lung disease or develop endocarditis secondary to septic jugular thrombophlebitis

Question 11

Congestive heart failure is a result of __ or secondary to __ or __. The notable clinical signs are __ intolerance, dependent __, and pronounced __.

Answer 11

Congestive heart failure is a result of vavular regurgitation or secondary to myocarditis or pericarditis. The notable clinical signs are exercise intolerance, dependent edema , and pronounced jugular pulses

Question 12

What are the goals of valvular regurgitation?

Answer 12

1. Decrease after load and cardiac work
2. Slow the progression of cardiac chamber enlargement
3. Improve cardiac contractility

Question 13

Benazepril

Answer 13

Benazepril is an ACE inhibitor that decreases afterload (decrease systemic vascular resistance) improving systolic function and cardiac output.

Question 14

Digoxin

Answer 14

Digoxin is a cardiac glycosides that reduces vasoconstriction, slows the heart rate and improves stroke volume. It’s a therapeutic drug so monitoring isn’t necessary

Question 15

Diuretics

Answer 15

Diuretics reduce preload, and may slow the rate of cardiac chamber dilation

Torsemide is newer and and oral option

Question 16

Infective endocarditis is a microbial infection of the __ of the heart that will present with fever, weight loss, and an inflammatory leukogram with __ and __ along with concurrent __

Answer 16

Infective endocarditis is a microbial infection of the endothelium of the heart that will present with fever, weight loss, and an inflammatory leukogram with hyperfibrinogenemia and hyperglobulinemia along with concurrent arrhythmias

Question 17

What is the most common congenital cardiac anomaly?

Answer 17

VSD’s

Question 18

PDA is a __ sided __ murmur that often changes to __ with age or closure. It’s not pathologic if it closes by __ days and blood flows from the __ to the __.

Answer 18

PDA is a left sided continuous murmur that often changes to systolic with age or closure. It’s not pathologic if it closes by 7days and blood flows from the aorta to the PA.

Question 19

A ventricular septal defect results in pulmonary hypertension as a result of __ heart failure or primary lung disease may result in reversal of blood flow from the __ to the __ and clinical signs of __

Answer 19

A ventricular septal defect results in pulmonary hypertension as a result of L sided heart failure or primary lung disease may result in reversal of blood flow from the R to the L and clinical signs of cyanosis

Question 20

What is the primary murmur of a ventricular septal defect?

Answer 20

Right sided systolic murmur

Question 21

A restrictive VSD is less than __ cm and has a __ prognosis for athleticism

Answer 21

A restrictive VSD is less than 2.8 cm and has a good prognosis for athleticism