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Journal of Veterinary Cardiology : the... Dec 2015A dog or a cat has an incidentally detected heart murmur if the murmuris an unexpected discovery during a veterinary consultation that was not initially focused on the... (Review)
Review
A dog or a cat has an incidentally detected heart murmur if the murmuris an unexpected discovery during a veterinary consultation that was not initially focused on the cardiovascular system. This document presents approaches for managing dogs and cats that have incidentally-detected heart murmurs, with an emphasis on murmur characteristics, signalment profiling, and multifactorial decision-making to choose an optimal course for a given patient.
Topics: Animals; Cat Diseases; Cats; Decision Trees; Diagnostic Techniques, Cardiovascular; Dog Diseases; Dogs; Heart Murmurs; Incidental Findings
PubMed: 26777392
DOI: 10.1016/j.jvc.2015.05.001 -
Equine Veterinary Journal. Supplement Sep 1995Physiological flow murmurs occur frequently in horses and may be difficult to distinguish from murmurs associated with underlying cardiac disease. The significance of... (Review)
Review
Physiological flow murmurs occur frequently in horses and may be difficult to distinguish from murmurs associated with underlying cardiac disease. The significance of heart murmurs auscultated in horses is often difficult to determine if the horse is not exhibiting any clinical signs or if the signs, such as poor performance, are nonspecific. A complete echocardiographic examination (M-mode, 2-dimensional (2-D) and Doppler) provides an objective assessment of the severity of the horse's underlying cardiac disease. Valvular regurgitation and ventricular septal defects (VSDs) occur frequently and may impair performance, result in the horse's premature demise or have no apparent effect on the horse's life expectancy or performance capabilities. The echocardiographic findings that are used to formulate a prognosis for longevity and performance in horses with valvular regurgitation include the abnormalities detected on the valve leaflets, degree of cardiac chamber enlargement, severity of the resultant volume overload, size of the regurgitant jet, and relative relationship of jet size to chamber size. The echocardiographic findings that are used to formulate a prognosis for horses with VSDs are the number, size and location of the defect(s), degree of left ventricular volume overload, maximal velocity and direction of shunt flow through the defect and the presence and severity of concurrent valvulus regurgitation. Knowledge of the natural progression of the common types of cardiovascular disease in horses, coupled with the echocardiographic findings, clinical history and owner's or trainer's expectations can help the veterinarian form an accurate prognosis for life and performance in horses with heart murmurs.
Topics: Animals; Echocardiography; Echocardiography, Doppler; Heart Murmurs; Heart Valve Diseases; Heart Valves; Horse Diseases; Horses; Prognosis
PubMed: 8933072
DOI: 10.1111/j.2042-3306.1995.tb04992.x -
Circulation Mar 1975Diastolic murmurs associated with the Starr-Edwards mitral prosthesis have not been described previously. In this report, five patients with mitral prostheses are...
Diastolic murmurs associated with the Starr-Edwards mitral prosthesis have not been described previously. In this report, five patients with mitral prostheses are described in whom apical mid-diastolic and presystolic murmurs resulted from two different causes. Three patients had clots obstructing the prosthetic orifice. The other two had normally functioning protheses and moderately severe aortic insufficiency. The occurrence of mid-diastolic and presystolic murmurs in the presence of a normally functioning prosthetic mitral valve demonstrates that 1) the mid-diastolic Austin Flint murmur can occur in the absence of incomplete mitral valve opening, premature mitral valve closure, vibrating mitral leaflets, or relative mitral stenosis and 2) the presystolic Austin Flint murmur can occur in the absence of incomplete valve opening or presystolic mitral regurgitation. However, the presystolic murmur was associated with early closure movement of the presthetic poppet.
Topics: Adult; Aortic Valve Insufficiency; Female; Heart Auscultation; Heart Murmurs; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve Insufficiency; Mitral Valve Stenosis; Phonocardiography; Thrombosis
PubMed: 1139752
DOI: 10.1161/01.cir.51.3.402 -
The Journal of Small Animal Practice Sep 2013
Topics: Animals; Dog Diseases; Dogs; Heart Defects, Congenital; Heart Murmurs
PubMed: 23964861
DOI: 10.1111/jsap.12128 -
Journal of the American Heart... Oct 2023Background The success of cardiac auscultation varies widely among medical professionals, which can lead to missed treatments for structural heart disease. Applying...
Background The success of cardiac auscultation varies widely among medical professionals, which can lead to missed treatments for structural heart disease. Applying machine learning to cardiac auscultation could address this problem, but despite recent interest, few algorithms have been brought to clinical practice. We evaluated a novel suite of Food and Drug Administration-cleared algorithms trained via deep learning on >15 000 heart sound recordings. Methods and Results We validated the algorithms on a data set of 2375 recordings from 615 unique subjects. This data set was collected in real clinical environments using commercially available digital stethoscopes, annotated by board-certified cardiologists, and paired with echocardiograms as the gold standard. To model the algorithm in clinical practice, we compared its performance against 10 clinicians on a subset of the validation database. Our algorithm reliably detected structural murmurs with a sensitivity of 85.6% and specificity of 84.4%. When limiting the analysis to clearly audible murmurs in adults, performance improved to a sensitivity of 97.9% and specificity of 90.6%. The algorithm also reported timing within the cardiac cycle, differentiating between systolic and diastolic murmurs. Despite optimizing acoustics for the clinicians, the algorithm substantially outperformed the clinicians (average clinician accuracy, 77.9%; algorithm accuracy, 84.7%.) Conclusions The algorithms accurately identified murmurs associated with structural heart disease. Our results illustrate a marked contrast between the consistency of the algorithm and the substantial interobserver variability of clinicians. Our results suggest that adopting machine learning algorithms into clinical practice could improve the detection of structural heart disease to facilitate patient care.
Topics: Adult; Humans; Deep Learning; Heart Murmurs; Heart Diseases; Heart Auscultation; Algorithms
PubMed: 37830333
DOI: 10.1161/JAHA.123.030377 -
Archives Des Maladies Du Coeur Et Des... Oct 1987
Review
Topics: Diastole; Echocardiography; Heart Auscultation; Heart Murmurs; Humans
PubMed: 3128214
DOI: No ID Found -
Klinicheskaia Meditsina 1993The paper presents the review of the literature data and the results of the authors' own experience in the aspects of the origin and clinical interpretation of... (Review)
Review
The paper presents the review of the literature data and the results of the authors' own experience in the aspects of the origin and clinical interpretation of "innocent" cardiac murmurs (ICM). It was suggested that ICM were a regular phenomenon in the majority of the young people. Contradictions in current views on the problem of ICM appearance were discussed from the point of view of the leading importance of disproportion in the development of the major vessels and cardiac cavities, systolic regurgitation at atrioventricular valvular dysfunction, hyperkinetic cardiac effects. The paper presents the data which permit one to consider morphofunctional features of intracardiac structures violating the uniformity and equality in the cardiac release tracts as leading causes of ICM appearance. Pathogenetic unity of ICM and organic murmurs was distinguished as the manifestation of murmuring turbulent flows. Principle difference between the leading mechanisms of these murmurs occurrence was discussed as well.
Topics: Adolescent; Adult; Age Factors; Child; Echocardiography; Heart Auscultation; Heart Murmurs; Heart Sounds; Hemodynamics; Humans; Phonocardiography
PubMed: 8301981
DOI: No ID Found -
Tidsskrift For Den Norske Laegeforening... Apr 2005Many normal children have heart murmurs, but most children do not have heart disease. Differentiation of innocent murmurs from those due to structural heart disease,... (Review)
Review
BACKGROUND
Many normal children have heart murmurs, but most children do not have heart disease. Differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is largely clinical.
MATERIAL AND METHODS
This review is based upon the authors' own studies and PubMed searches.
RESULTS
An appropriate history and a properly conducted physical examination can identify children at risk of significant heart disease.
INTERPRETATION
If a murmur cannot clearly be labelled as innocent based on characteristics like sound quality, intensity, location and response to posture, then referral to a paediatric cardiologist is indicated. Other indications for referral are any sign or symptom of cardiovascular disease such as shortness of breath, cyanosis or decreased exercise tolerance. In addition, children with syndromes should, because of their high risk of congenital heart disease, be referred to a paediatric cardiologist for further evaluation.
Topics: Child; Heart Defects, Congenital; Heart Murmurs; Humans; Physical Examination; Practice Guidelines as Topic; Referral and Consultation
PubMed: 15852070
DOI: No ID Found -
The Journal of Small Animal Practice Feb 2015
Topics: Animals; Dog Diseases; Female; Heart Murmurs; Male
PubMed: 25627352
DOI: 10.1111/jsap.12334 -
Circulation Journal : Official Journal... Oct 2016
Topics: Echocardiography; Female; Heart Murmurs; Heart Neoplasms; Humans; Middle Aged; Phonocardiography
PubMed: 27581059
DOI: 10.1253/circj.CJ-16-0804