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Acute onset murmur

Sonopath Forum

Acute onset murmur

  • 8 year old ME terrier with no history of murmur but then owner could hear murmur 
  • G 4/6 apical systolic murmur, HR 120, normal respiration
  • Suspect flail tip of posterior leaflet of mitral valve due to cord rupture with moderate eccentric mitral regurgitation
  • Left atrium and ventricle are a normal size, I suspect LA has not had time to dilate
  • Would you start this dog on pimobendan? 
  • I recommended repeat echo in 3-6 months but this may not be feasible

  • 8 year old ME terrier with no history of murmur but then owner could hear murmur 
  • G 4/6 apical systolic murmur, HR 120, normal respiration
  • Suspect flail tip of posterior leaflet of mitral valve due to cord rupture with moderate eccentric mitral regurgitation
  • Left atrium and ventricle are a normal size, I suspect LA has not had time to dilate
  • Would you start this dog on pimobendan? 
  • I recommended repeat echo in 3-6 months but this may not be feasible

Comments

Peter

Hi!
If the dog is not

Hi!

If the dog is not clinically normal and since the EPIC criteria are obviously not met (LA:AO 1.4), I would not recommend starting Pimobendan now. 

As you said, this is likely some acute chordal rupture. But if it was rupture of a main chordae then the dog would be in acute CHF even though sizes are normal. These dogs usually have very tall E-waves on mitral inflow (> 1.4 m/s). In this case I would still start with Pimobendan even though the EPIC criteria are not met.

Otherwise a re-check will be necessary. 

If the owners can’t afford this, I would go for re-check xrays in 3 months.

 

Peter