Relationship between auscultation vs regurgitation (cm/s) and murmur

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Relationship between auscultation vs regurgitation (cm/s) and murmur

  • I started to do echocardiography a short time ago (few weeks).
  • Poodle, 10 years, 10kg. Preoperative checkup, suspected of osteosarcoma extraosseous.  Cardiac murmur grade 1, systolic pressure 110, thoracic RX within normal range, without cough.
  •  Findings: concentric hypertrophy? 
  • AV max: 117cm/s , PV max: 154cm/s, IVRT: 77ms, TAPSE: 1cm, E/A: 0,9

    • I started to do echocardiography a short time ago (few weeks).
    • Poodle, 10 years, 10kg. Preoperative checkup, suspected of osteosarcoma extraosseous.  Cardiac murmur grade 1, systolic pressure 110, thoracic RX within normal range, without cough.
    •  Findings: concentric hypertrophy? 
    • AV max: 117cm/s , PV max: 154cm/s, IVRT: 77ms, TAPSE: 1cm, E/A: 0,9
    •  Ae/AO: 1.5 (LA = 1,8 / Ao = 1.3?)  Aorta with decreased size? It may be the technique, I have difficulties in making this view (right parasternal transverse heart base: aorta and left atrium)
    • In this specific patient i had difficulty achieving the EPSS (Can be SAS)?
    • Is the murmur grade 1 compatible with this regurgitation and pressure gradient?
    • What might explain this concentric hypertrophy?

       

      Thanks all!

      Adams.

       

Comments

EL
June 28, 2017 at 11:43 pm -

Im not appreciating any

Im not appreciating any concentric hypertrophy i your m-mode or your apical but the 4 chamber subjectively looks thick I agree but may be the angle. Eyeballing the ivsd and fwd they are both about 8 mm. The mv is a touch vegetative and you have a regurg wave form which I think is over the mv in the still image but not sure. Its a thin jet and about 5.8 m/sec which would fit with a minor mr. I dont see anything clinical here though.

 

gadams
June 29, 2017 at 8:17 pm -

Thanks for the support

Thanks for the support Eric! I’ll keep trying 🙂

 

 

Regards,

Adams.

randyhermandvm
July 3, 2017 at 1:46 pm -

As a side note.
Calculated L

As a side note.

Calculated L ventricular pressure utilizing a mitral jet of 5.8 m/sec.

Modified Bernoulli equation:

4(5.8 X 5.8)= 134.56- 8 (Estimated L atrial pressure)= 126 mmHg.

Not that far off from your blood pressure measurement- but still off a little. Good way to double check your cuff measurements.

I agree with EL 100%. This dogs heart murmur is the least of his worries if you suspect osteosarcoma.

gadams
July 4, 2017 at 10:28 pm -

Thanks for the great side

Thanks for the great side note Randy :))

 

 

Regards,

Adams.

EL
July 4, 2017 at 10:52 pm -

Side note on the echo help

Side note on the echo help beginner, intermediate and advanced tables to up your game with a day of cardio-pathology lecture with Mandi Klemen in Denver Oct 13-15. We still have some spots available but are closing it at 21 attendees. SDEP echo protocol if you haven’t tried it there is nothing more efficient out there to get all the views including Doppler and congential studies. Even if you take pieces of SDEP to add to your game its worth your time by saving time and improving views.

http://www.sonopath.com/events/2017-sonopath-sdep-ce-eventslecture-events

gadams
July 5, 2017 at 4:09 pm -

Thanks for the invitation
Thanks for the invitation Eric!

I’m from Brazil, but when possible, I’ll be in your courses. And the next time I come to Brazil I’ll be there.

Regards,
Adams.

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