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What is the most useful dx test for murmurs?

US

Grading murmurs based on sound and intensity is?

reliable

Grade ______ murmurs are only heard on auscultation and are very faint.

1

Grade ____ murmurs are likely the softest ones you will hear.

2 (grade one is almost silent)

Grade ____ murmurs are obvious and easy to detect w/ auscultation.

3

Grade _____ murmurs are easily detectable and heard over a large area.

4

Grade _____ murmurs produce a palpable thrill.

5

Grade ____ produce a thrill and can be heard w/ out auscultation.

6

Most murmurs and all pathological murmurs in horses are due to ______ and not ______.

regurg.; stenosis

If the murmur comes between s1 and s2 it is ________ and if it comes after s1 and s2 it is ______.

systolic; diastolic

Pan_____murmurs are heard during the pulse free interval.

pandiastolic

Pan ______ murmurs are heard during the pulse. (the opposite of the pulse free interval)

systolic

Murmurs in horses are ____ diastolic and systolic.

half and half

Aortic murmurs radiate ______.

downwards

Mitral murmurs radiate ______.

upwards

A LOUD systolic murmur heard on the left is probably?

mitral regurg

A LOUD diastolic murmur heard on the left is probably?

aortic regurg.

A MILD murmur heard on the left side in a fit race horse is probably? what is relevant about this? how can you be sure?

mitral regurg; can be normal in a racing animal via physiological hypertrophy keeping valves from closing all the way; if it goes away after exercise

The most common physiological murmur in a foal is? how long is it normal?

PDA; up to 7 days

When might a foal have a normal physiological murmur due to a PDA after 7 days?

when they are sick it might take longer to close

_____% of race horses have some sort of murmur.

80%

The ECG is _____ for detection of murmurs.

s hit

Why are aortic flow murmurs physiological in the horse?

they are produced by the normal blood flow thru the aorta in a horse

Diastolic filling murmurs are ________ and sound like small clicks. They are grade 1 only.

physiological

Loud systolic murmurs, grade 4 or higher, that are very obvious are _______ in sick animals and will?

physiological; go away after the animal gets better

Which dz of the blood can cause murmurs? how?

anemia; changes in blood viscosity

Be careful to not confuse murmurs due to ______ with ones due to cardiac dz.

illness (colic, painful conditions)

Severely sick horses will generally have ______.

murmurs

What is the most common congenital cardiac defect in horses?

VSD

What is unique about the murmurs assoc. with VSD?

there are two; systolic murmur is on the right(due to relative pulmonic stenosis from excess blood coming from left to right) and left (thru defect)

T/F 1/2 of VSD's are small and asymptomatic.

T

VSD's cause _____ CHF.

right

mitral regurg. murmurs are heard on the _____ side of the animal.

left

Which murmur of horses causes the most problems? When are they not an issue?

mitral regurg; grade 3 or less

Mitral regurg. is a dz in horses older than?

6yrs

When does mitral regurg. present w/ a sudden onset?

when chordae tendonae rupture

A grade 5 murmur w/ thrill due to mitral regurg. is always considered?

pathological

mitral regurg. causes _____ CHF.

left

What other pathology of the heart can be confused w/ mitral regurg.?

aortic flow murmurs

Mitral regurg. is mainly a problem in ______ horses and the changes are ______.

high performance/racing; degenrative

Which murmur is only a problem of horses 10+?

aortic regurg.

Which murmur is the only common cause of a diastolic murmur in horses?

aortic regurg.

T/F aortic regurg. is only heard on the left.

F; both sides

How do you know if aortic regurg. is severe?

if there are bounding pulses

What arrhythmia can be a sequelae of aortic regurg?

VPC

T/F the louder an aortic regurg. murmur is, the worse it is.

f; loudness is not an indicator of severity; use pulse to help determine severity

An aortic regurg. w/ a bounding pulse is clinically ______.

pathological

Valvular degeneration and endocardiosis are two causes of this murmur in older horses.

aortic regurg.

Which rare murmur causes v-tach due to hemorrhage into the intraventricular septum?

aortic root fistula; ruptured sinus of velselva

Which serious dz of older stallions usually causes death with in a year, but causes low grade murmurs?

aortic root fistula

What is one heart problem that can cause colic?

aortic root fistula

What is the tx for aortic root fistulas?

lidocaine; for symptoms; wont cure; dead in a year

Bacterial endocarditis will present how?

NOT as cardiac dz, but febrile dz

A febrile horse w/ wt.loss, and joint dz is most likely to have this cardiac pathology.

endocarditis

What is the dx, tx, and px for endocarditis in horses?

dx = ultrasound, tx = abx, px = poor

Crackles heard when auscultating the horse can indicates ______ CHF if the lungs are healthy.

left

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