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The Journal of Veterinary Medical... Sep 2023A 1-month-old crossbred calf was referred for examination due to marked systolic heart murmurs and poor growth. The heart murmur was most audible on the right side of...
A 1-month-old crossbred calf was referred for examination due to marked systolic heart murmurs and poor growth. The heart murmur was most audible on the right side of the cranial thorax. Cardiomegaly was evident on chest radiography, and echocardiography demonstrated aortic regurgitation and decreased fractional shortening. Cardiomegaly, aortic root dilation and cardiac displacement were confirmed by computed tomography. At necropsy, the heart was enlarged, and all three aortic valve leaflets were irregularly shaped. In calves with chronic aortic insufficiency, remodeling displacement of the heart and aorta causes changes in the location and timing of heart murmurs. Therefore, aortic insufficiency cannot be ruled out when a systolic heart murmur can be observed in the right chest wall.
Topics: Animals; Cattle; Aortic Valve Insufficiency; Aortic Valve; Heart Murmurs; Echocardiography; Cardiomegaly; Cattle Diseases
PubMed: 37532587
DOI: 10.1292/jvms.23-0139 -
The Tohoku Journal of Experimental... Feb 1954
Topics: Heart Murmurs; Heart Sounds; Phonocardiography
PubMed: 13169160
DOI: 10.1620/tjem.59.307 -
Journal of the American Veterinary... May 2015
Review
Topics: Animals; Cat Diseases; Cats; Decision Trees; Diagnostic Techniques, Cardiovascular; Dog Diseases; Dogs; Heart Murmurs; Incidental Findings
PubMed: 25932933
DOI: 10.2460/javma.246.10.1076 -
Proceedings of the Royal Society of... Jan 1959
Topics: Cardiovascular Abnormalities; Cardiovascular System; Heart Murmurs; Heart Sounds; Prognosis
PubMed: 13623858
DOI: No ID Found -
Journal of Veterinary Internal Medicine 2008Cardiac murmurs associated with valvular regurgitation occur commonly in conditioned performance horses, but their association with athletic performance is unknown.
BACKGROUND
Cardiac murmurs associated with valvular regurgitation occur commonly in conditioned performance horses, but their association with athletic performance is unknown.
HYPOTHESIS
Cardiac valvular regurgitation has a negative association with race performance.
ANIMALS
Five hundred and twenty-six "race fit" Thoroughbred racehorses engaged in either flat (race distance 1,000-2,500 m) or jump racing (race distance 3,200-6,400 m).
METHODS
Cardiac auscultation and color flow Doppler (CFD) echocardiography were performed on 777 occasions. The associations between the presence and severity of either an audible cardiac murmur or valvular regurgitation assessed by CFD, and published, objective measures of race performance were determined using a standard regression approach.
RESULTS
The prevalence of murmurs and of regurgitation varied significantly between racetypes (P<.02), generally increasing from 2-year olds to chasers. There were no consistent associations between racing performance and either grade of murmur or regurgitation, whether the presence or absence of regurgitation or murmur, or only murmurs > or =3/6 or regurgitation > or =6/9, were considered.
CONCLUSIONS AND CLINICAL IMPORTANCE
There were differences in prevalence and severity of murmurs of atrioventricular and aortic valve regurgitation between racehorses in different disciplines. Data also showed that neither regurgitation nor murmurs were negatively associated with Timeform rating, an index of UK racehorse quality, in any of the groups of racehorses studied.
Topics: Animals; Echocardiography, Doppler, Color; Female; Heart Auscultation; Heart Murmurs; Heart Valve Diseases; Horse Diseases; Horses; Male; Physical Conditioning, Animal; Prevalence; Severity of Illness Index
PubMed: 18346144
DOI: 10.1111/j.1939-1676.2008.0053.x -
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 -
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 -
Circulation Journal : Official Journal... Feb 2022Coexistent pulmonary hypertension with severe aortic stenosis confers a greater risk of mortality for patients undergoing transcatheter aortic valve replacement (TAVR)....
BACKGROUND
Coexistent pulmonary hypertension with severe aortic stenosis confers a greater risk of mortality for patients undergoing transcatheter aortic valve replacement (TAVR). In this patient population, the impact of significant decoupling between pulmonary artery diastolic and pulmonary capillary wedge, as it relates to clinical risk, remained uncertain.Methods and Results:Patients with severe aortic stenosis who underwent TAVR and completed pre-procedural and post-procedural invasive hemodynamic assessments with right heart catheterization were retrospectively assessed. The impact of post-TAVR decoupling, defined as a pressure difference ≥3 mmHg, on 2-year all-cause mortality or risk of heart failure admission was analyzed. Among 77 included patients (median age 86 years, 23 men), 16 had post-TAVR decoupling. The existence of post-TAVR decoupling was associated with a higher cumulative incidence of the primary endpoint (44% vs. 7%, P=0.001), with an adjusted hazard ratio of 5.87 (95% confidence interval 1.58-21.9, P=0.008).
CONCLUSIONS
A greater risk of worse outcomes in those with post-TAVR decoupling was observed. A therapeutic strategy for post-TAVR decoupling and its clinical implication need to be created and investigated in the future.
Topics: Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Heart Murmurs; Humans; Male; Pulmonary Artery; Pulmonary Wedge Pressure; Retrospective Studies; Risk Factors; Severity of Illness Index; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 34602582
DOI: 10.1253/circj.CJ-21-0573 -
Journal of Veterinary Cardiology : the... Aug 2017To assess the prevalence of functional ejection murmurs and murmurs of mitral regurgitation (MR) due to myxomatous mitral valve disease in healthy whippets; to assess...
OBJECTIVES
To assess the prevalence of functional ejection murmurs and murmurs of mitral regurgitation (MR) due to myxomatous mitral valve disease in healthy whippets; to assess the diagnostic value of auscultation to detect MR; and investigate the relationship between age and presence of echocardiographically documented MR (MR).
ANIMALS
A total of 200 healthy client-owned Whippets, recruited at national shows between 2005 and 2009 were involved in this study.
METHODS
Cross-sectional study. Dogs were examined by auscultation by one examiner and Doppler echocardiography by another, and results were compared. Prevalence of types of murmurs and MR were calculated and correlated to age. Accuracy of auscultation to predict MR was calculated.
RESULTS
Left-sided systolic heart murmurs were detected in 185/200 (93%) of dogs. Left apical systolic murmurs (L) were detected in 57/200 (29%) and left basilar systolic murmurs (L) in 128/200 of the dogs (64%). MR was present in 76/200 (38%) dogs. Prevalence MR was correlated with age (r = 0.96, p=0.0028). Mitral regurgitation detected by echocardiography was present in 12/78 (15%) of the dogs ≤ 2 years of age and in 59% of the dogs at 7-8 years old. Detection of L predicted MR with sensitivity 65%, specificity 94%, positive predictive value 86%, and negative predictive value 81%; and accuracy improved when only dogs with more intense L (grade ≥ 3/6) were considered.
CONCLUSIONS
Systolic murmurs are common in North American Whippets and this breed exhibits a high prevalence of MR, which may be documented at a relatively early age. Whippets with non-clinical MR may not be identifiable by auscultation alone; echocardiographic examination may be required to exclude a diagnosis of MR. Louder heart murmurs allow more accurate localization in this population.
Topics: Animals; Cross-Sectional Studies; Dog Diseases; Dogs; Echocardiography; Female; Heart Murmurs; Male; Mitral Valve; Mitral Valve Insufficiency; Prevalence; United States
PubMed: 28666945
DOI: 10.1016/j.jvc.2017.04.004 -
Biomedical Engineering Online Aug 2018There are two major challenges in automated heart sound analysis: segmentation and classification. An efficient segmentation is capable of providing valuable diagnostic...
BACKGROUND
There are two major challenges in automated heart sound analysis: segmentation and classification. An efficient segmentation is capable of providing valuable diagnostic information of patients. In addition, it is crucial for some feature-extraction based classification methods. Therefore, the segmentation of heart sound is of significant value.
METHODS
This paper presents an automatic heart sound segmentation method that combines the time-domain analysis, frequency-domain analysis and time-frequency-domain analysis. Employing this method, the boundaries of heart sound components are first located, and the components are then recognized. Finally, the heart sounds are divided into several segments on the basis of the results of boundary localization and component identification.
RESULTS
In order to evaluate the performance of the proposed method, quantitative experiments are performed on an authoritative heart sound database. The experimental results show that the boundary localization has a sensitivity (Se) of 100%, a positive predictive value (PPV) of 99.3% and an accuracy (Acc) of 99.93%. Moreover, the Se, PPV and Acc of component identification reach 98.63, 99.86 and 98.49%, respectively.
CONCLUSION
The proposed method shows reliable performance on the segmentation of heart sounds. Compared with previous works, this method can be applied to not only normal heart sounds, but also the sounds with S3, S4 and murmurs, thus greatly increasing the applied range.
Topics: Automation; Heart Murmurs; Heart Sounds; Signal Processing, Computer-Assisted
PubMed: 30081909
DOI: 10.1186/s12938-018-0538-9