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Equine Murmurs

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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