This is an 11 year old Beagle/Hound cross that presented in repiratory dyspnea. No obvious murmur was heard. Possibly a very low grade very low frequency murmur could be heard after careful auscultation. Could not be heard initialy but could just barely be distinguished following lasix.
I believe my color doppler and PW/CW doppler shows regurgitant flow at the mitral valves but confused about why a murmur is not heard.
This is an 11 year old Beagle/Hound cross that presented in repiratory dyspnea. No obvious murmur was heard. Possibly a very low grade very low frequency murmur could be heard after careful auscultation. Could not be heard initialy but could just barely be distinguished following lasix.
I believe my color doppler and PW/CW doppler shows regurgitant flow at the mitral valves but confused about why a murmur is not heard.
The Left atrium is markedly enlarged. The Left ventricle appears to be suffering some mycardial failure. So I believe that there truly is heart failure present and mitral regurge but cannot rationalize the very low grade murmur.
The PV, AOV, TV all had normal doppler readings and the only area we found an abnormality was the MV.
The heart looks abnormal to me with an elevated EPSS.
I have information regarding the presence or absence of murmurs in “Cats” with preclinical cardiac disease and I believe that 13% of cats with preclinical cardiac disease will not have audible murmurs.
However, this is a clinical dog.
So my questions are, based on my CW readings that I posted, is there a flaw in my technique. (Doppler and M Mode).If yes to these questions I will go back and repeat. On the one view the E and A waves are evident so I assume I am measuring in the correct position.(Welcome criticism)
If technique is adequate, can we have MVD, regurge that is significant enough to cause heart disease, but not cause an obvious murmur detectable with a stethoscope? With my CW readings I see a symmetrical, not overly dense regurge indicating low atrial pressures? I am not sure how to interpret this. Could this simply mean that there is a low volume of blood flowing through the mitral valve, therefore not audible and therefore look somewhere else for your heart problem? Or, this is the problem?
Thanks. Brent
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Unfortunately for some reason
Unfortunately for some reason the jpegs I loaded didn’t get added to the post. I’ll try again.
Unfortunately for some reason
Unfortunately for some reason the jpegs I loaded didn’t get added to the post. I’ll try again.
I recently had a dog in for a
I recently had a dog in for a practice echo and I found a mitral regurg and I went back and listened and I could not hear a murmur. His mitral jet measured about 5.5 cm/sec.
Mitral regurg should be over 5 cm/sec if you are lined up correctly because of L ventricular pressures.
You need to change the baseline on your doppler. Color flow with alignment would be nice. Can’t see the full extent of the doppler.
General observation- it appears that L ventricular function is decreased and there does not appear to be any compensatory hypertrophy of the IVS or VFW which you would like to see with MI.
The EPSS is also elevated. I would be concerned about some sort of dilated cardiomyopathy.
We can weigh in and see what the experts say.
I recently had a dog in for a
I recently had a dog in for a practice echo and I found a mitral regurg and I went back and listened and I could not hear a murmur. His mitral jet measured about 5.5 cm/sec.
Mitral regurg should be over 5 cm/sec if you are lined up correctly because of L ventricular pressures.
You need to change the baseline on your doppler. Color flow with alignment would be nice. Can’t see the full extent of the doppler.
General observation- it appears that L ventricular function is decreased and there does not appear to be any compensatory hypertrophy of the IVS or VFW which you would like to see with MI.
The EPSS is also elevated. I would be concerned about some sort of dilated cardiomyopathy.
We can weigh in and see what the experts say.
Looks like you are getting
Looks like you are getting lung interference into your doppler flow dampening the signal and there is myocardial insufficiency dampering the flow as well. This along with respiratopry interferenceis likely cloaking the auscoltability of the murmur. DCM possible but its really easy to be off line on short axis wiht the epss… the closest distance wins here so double check in rt ps 4 chamber long.
Looks like you are getting
Looks like you are getting lung interference into your doppler flow dampening the signal and there is myocardial insufficiency dampering the flow as well. This along with respiratopry interferenceis likely cloaking the auscoltability of the murmur. DCM possible but its really easy to be off line on short axis wiht the epss… the closest distance wins here so double check in rt ps 4 chamber long.