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I can’t find the murmur

Sonopath Forum

Sonopath Forum

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
November 21, 2015 at 5:27 pm -

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
November 22, 2015 at 1:05 am -

Hi Pete,
Yes, that does help!

Hi Pete,

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

Good day from Melbourne!:)

Regards,

Pris

EL
November 23, 2015 at 2:06 pm -

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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