I can’t find the murmur

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I can’t find the murmur

Hi all,

I’m stuck on this case. A 19 week old female entire DSH that was recently diagnosed with a grade III/VI heart murmur, pansystolic and point of maximal intensity is on the left side. The only problem is, i can’t find the murmur. Aortic flow velocity and pulmonic flow velocity were normal. LV measurements were all normal I could not see any mitral or tricuspid dysplasia. I also looked for ASD and VSD as well as DRVOTO. Have a missed something?

Hi all,

I’m stuck on this case. A 19 week old female entire DSH that was recently diagnosed with a grade III/VI heart murmur, pansystolic and point of maximal intensity is on the left side. The only problem is, i can’t find the murmur. Aortic flow velocity and pulmonic flow velocity were normal. LV measurements were all normal I could not see any mitral or tricuspid dysplasia. I also looked for ASD and VSD as well as DRVOTO. Have a missed something?

Comments

Peter

Hi!
The good thing is, you

Hi!

The good thing is, you are not the only one who has frustrating experiences like this one, also cardiologists sometimes have a hard time finding the origing of the murmurm in cats.

Fact is, the prevalence of heart murmurs in stressed cats is almost 2x the prevalence in non-stressed cats. Means that once the cat is in a comfortable position, the murmur can disappear.

Most of these murmurs are dynamic ones and need careful mapping of the RVOT and LVOT with PW-Doppler to find a dynamic flow acceleration (dagger-shaped profile). To rule out a VSD in a cat always look at short axis views of the left ventricle and the heart base. So-called supracristal defects and muscular defects can be missed on right parasternal long-axis views.

Hope this helps

 

best regards from Austria!

Peter

lookpris

Hi Pete,
Yes, that does help!

Hi Pete,

Yes, that does help! thank you so much:) 

Good day from Melbourne!:)

Regards,

Pris

EL

You can also reduice your CF

You can also reduice your CF sampling size by about 1/2 of what you show here and the Cf will be more precise and get less body motion artifact.

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