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Eff Yeah Sunny!
Dedicated to It's Always Sunny in Philadelphia and other things that I like.
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#it's always sunny in philadelphia#its always sunny in philadelphia#charlie kelly#charlie day#kaitlin olson#lord of the rings
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Grading and Description of Heart Murmurs
First things first. What even is a heart murmur? A heart murmur is turbulent blood flow that makes an audible sound. This can be commonly described as a whooshing. I like to think of a normal heart having a clear and precise lub-dub. A murmur would instead sound like lub-whoosh-dub. You can listen to some heart murmurs (listen to the normal ones first!!!) here and here.
GRADING: (out of a 1-6 scale)
I: Not distinct, lengthening of the first heart sound. (The “Aint no chance in heck I’m hearing this one.”)
II: Distinct, but very soft (The “Well maybe I can hear it? Wait… No… Wait… Yes??” Murmur).
III: Distinct, can be moderately loud. (The “okay I think I hear one! Wait is that just breathing noises?? Wait no there is one I think.” murmur)
IV: Very loud all over (The “Ah I can hear this one!” murmur)
V: Very loud, and if you put your hand on the heart, you can feel a thrill (vibration) (The “holy cow this feels weird!” murmur )
VI: VERY loud, with a thrill, and can hear it with a stethoscope without touching the body wall (The “OMG I can hear this on the dog’s forehead!” murmur)
-Tip: There is not always a direct correlation between murmur grade and severity of heart disease. In fact there are certain diseases (like in a Ventricular Septal Defect where there is a hole between the ventricles) where a higher grade murmur normally means a smaller hole! In the same line of thought, not all murmurs are related to heart disease!! Some low grade (<3) murmurs can be “physiologic” or “innocent.”
TIMING:
The timing for heart murmurs relate to when the murmur is heard in the heart cycle! Systolic (lub-whoosh-dub), Diastolic (lub-dub-whoosh), and Continuous (whooshing all the time!!!) murmurs are the usual suspects (other ones, like pan, holo, etc exist as well).
-Tip: Most heart murmurs (in dogs) are SYSTOLIC!!!
-Tip: Continuous murmurs in dogs are often caused by a congenital condition called a PDA (Patent Ductus Arterious), and sound (to me!) like shoes in a dryer!
LOCATION:
As mentioned in this post of mine, you can have basilar or apical locations for heart murmurs! (Or parasternal, if you are a cat…). The heart BASE is the top of the heart by the shoulder, and the APEX of the heart is closer to the sternum
Example murmur description: Grade III/VI left systolic apical heart murmur
-Tip: Identifying murmurs (especially low grade ones) can be HARD! Do NOT feel bad for not catching them! It takes years and years of listening to normal hearts to discover the abnormal ones, so don’t beat yourself up for not immediately hearing that grade II/VI heart murmur! It takes time and practice!
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The Poster Doggies of Heart Disease
Disclaimer: The following is a list of breeds and the heart diseases they can commonly get. I am NOT saying only this breed gets this disease, nor am I saying that every dog of this breed will get this disease. This is simply a short list of the common doggies one thinks of when examining a particular heart disease. So without further ado:
-> Doberman Pinscher: Dobies are prone to Dilated Cardiomyopathy, or DCM. This is a disease where the heart becomes enlarged and dilated, and is unable to contract and therefore pump blood properly. This commonly results in congestive heart failure.
-> Cavalier King Charles Spaniel: Oh my cute little spaniels… I don’t think I’ve met one yet without a heart murmur. These get Mitral Valve Degeneration (also known as Endocardiosis). This is a relatively common change in the valves where they become knobby and unable to close correctly. This allows moderate to insane amounts of blood to spill back into the atrium (called regurgitation), which is the main reason you hear a murmur, and of course causes the heart to work harder.
-> Boxers: Nothing says poster child like having a disease named after you. Boxer Cardiomyopathy, or Boxer arrhythmogenic right ventricular cardiomyopathy (ARVC), if you want to get fancy. This is the disease of the heart’s muscle (myocardium), that results in some serious and sometimes fatal arrhythmias.
-> Miniature Schnauzer: Sick Sinus Syndrome, or AKA the heart auscultation that might just stop your own heart! I’ve recently heard one of these and just about fell over! This is a disease where the sinus node, a very crucial part of the heart that sends electrical pulses to help with heart rate and contraction, doesn’t work too well, resulting in a slow heart rate or even pauses in between beats.
Check out the ECG below. See the FLATLINE? The heart shouldn’t stop beating for that long!! No wonder these dogs often present for sudden collapse!
(image from lifeinthefastlane.com)
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As a veterinary professional, I’m a little crabby because I can’t get my physical, my dental cleaning, and my tumor removal done at the same place/same time.
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Hallie hates being in a crate (and she was worse than Queen for her nail trim)
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