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Cardiology (equine) > Murmurs > Flashcards

Murmurs Flashcards

1
Q

what are the aims of investigating heart murmurs in horses?

A

determine significance of performance, risk of collapse and progression

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2
Q

where is the apex beat of the horses heart?

A

over the mitral valve

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3
Q

what causes S1?

A

shutting of the AV valves (mitral/tricuspid)

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4
Q

what causes S2?

A

shitting of the seminar valves (aortic/pulmonic)

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5
Q

what causes S4?

A

atrial contraction

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6
Q

when is S4 heard in the cardiac cycle

A

just before S1

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7
Q

what causes S3?

A

end of rapid passive ventricular filling

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8
Q

what is S3 heard?

A

just after S2

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9
Q

what correlates to S4 on an ECG?

A

P wave

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10
Q

what causes a P wave?

A

depolarisation of the atrium

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11
Q

what causes the QRS complex?

A

depolarisation of ventricles

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12
Q

what causes the T wave?

A

repolarisation of ventricles

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13
Q

why does mitral valve regurgitation cause a load S3?

A

blood flows back into the atrium so the atrium becomes very full with blood, then when the ventricle relaxes there is a higher pressure of blood rushing into the ventricle (very rapid filling)

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14
Q

is diastole or systole shorter?

A

systole is shorter

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15
Q

as heart rate increases does the length of diastole or systole decrease?

A

systole (becomes harder to tell if a murmur is diastolic os systolic)

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16
Q

what causes murmurs?

A

turbulent flow of blood

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17
Q

what influences Reynolds number?

A

velocity, diameter of vessel, density, viscosity

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18
Q

what number influences turbulence?

A

Reynolds

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19
Q

what is Reynolds number?

A

(velocity x diameter x density) / viscosity

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20
Q

how does the diameter of the vessel influence the turbulence of blood?

A

large vessels have more turbulence

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21
Q

why do foals often have flow murmurs?

A

they are relatively anaemic, so the viscosity of the blood is lower so there is more turbulence to blood

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22
Q

how are murmurs graded?

A

1 - barely audible
2 - quite than S1/S2
3 - as loud as S1/S2
4 - louder than S1/S2
5 - very loud and palpable thrill
6 - audible with stethoscope off of chest

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23
Q

how can the timings of murmurs be described?

A

(early, mid, late, pan, holo) - systolic, diastolic, continuous

24
Q

what does pan- mean when describing murmurs?

A

covers over the normal heart sounds

25
Q

what do we use to describe murmurs?

A

grade
timing
point of maximum intensity
radiation
shape
quality

26
Q

how can the shape of a murmur be described?

A

plateau
crescendo (get louder)
decrescendo (get quieter)

27
Q

what are the two categories of murmurs?

A

physiological/functional
pathological

28
Q

when are flow murmurs heard?

A

early/mid systole

29
Q

are flow murmurs normal?

A

yes - physiological murmurs

30
Q

where can flow murmurs be localised to?

A

heart base

31
Q

what vessel are flow murmurs associated with?

A

aorta

32
Q

when are filling murmurs heard?

A

early diastole (between S2 and S3)

33
Q

what are the two main physiological murmurs?

A

flow and filling

34
Q

what age animals are filling murmurs heard in?

A

young, fit animals

35
Q

what kind of sound does a filling murmur make?

A

squeak

36
Q

what is the most common pathological murmur of horses?

A

mitral/tricuspid regurgitation

37
Q

what is the timing of a mitral valve regurgitation murmur?

A

holo/pansystolic

38
Q

what is the point of maximal intensity of mitral valve regurgitation murmur?

A

heart apex

39
Q

what is does if you find a grade 1-2 mitral valve regurgitation murmur?

A

monitor for progression

40
Q

what is does if you find a dare 3-6 mitral valve regurgitation murmur?

A

investigate further (echo)

41
Q

why are right sided murmurs less of a concern then left side?

A

lower pressure in the right side

42
Q

what aged horses are ventricular septal defect murmur usually detected in?

A

young horses

43
Q

which side of the heart are ventricular septal defect murmur loudest on?

A

right

44
Q

what is the timing of ventricular septal defect murmurs?

A

pansystolic

45
Q

why does a faster/louder ventricular septal defect murmur give a better prognosis?

A

means there is a smaller defect and the pressure difference is still large meaning the horse hasn’t gone into heart failure

46
Q

what age horses are aortic insufficiency/regurgitation murmurs seen in?

A

older horses (degenerative disorder)

47
Q

what is the timing of insufficiency/regurgitation murmurs?

A

holodiastolic

48
Q

what is the point of maximal intensity of insufficiency/regurgitation murmurs?

A

heart base

49
Q

what does a insufficiency/regurgitation murmur sound like?

A

moaning (teenage murmur) uhhhh

50
Q

what causes a continuous murmur?

A

patent ductus arteriosus

51
Q

where is the ductus arteriosus?

A

between the aorta and pulmonary artery

52
Q

when is a patent ductus arteriosus murmur normal?

A

foals up to 5 days old

53
Q

what is the point of maximal intensity of patent ductus arteriosus murmur?

A

heart base

54
Q

what are the main pathological murmurs?

A

mitral/tricuspid regurgitation
ventricular septal defect
aortic regurgitation
patent ductus arteriosus

55
Q

what are the two differentials for left systolic murmurs?

A

mitral regurgitation
aortic flow

56
Q

what are the two differentials for left diastolic murmurs?

A

aortic regurgitation
ventricular filling

57
Q

what are the two differentials for right systolic murmurs?

A

tricuspid regurgitations
ventricular septal defect

Cardiology (equine) (2 decks)

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