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American Journal of Veterinary Research Sep 2007To investigate whether time-frequency and complexity analyses of heart murmurs can be used to differentiate physiologic murmurs from murmurs caused by aortic stenosis... (Comparative Study)
Comparative Study
OBJECTIVE
To investigate whether time-frequency and complexity analyses of heart murmurs can be used to differentiate physiologic murmurs from murmurs caused by aortic stenosis (AS) in Boxers.
ANIMALS
27 Boxers with murmurs.
PROCEDURES
Dogs were evaluated via auscultation and echocardiography. Analyses of time-frequency properties (TFPs; ie, maximal murmur frequency and duration of murmur frequency > 200 Hz) and correlation dimension (T(2)) of murmurs were performed on phonocardiographic sound data. Time-frequency property and T(2) analyses of low-intensity murmurs in 16 dogs without AS were performed at 7 weeks and 12 months of age. Additionally, TFP and T(2) analyses were performed on data obtained from 11 adult AS-affected dogs with murmurs.
RESULTS
In dogs with low-intensity murmurs, TFP or T(2) values at 7 weeks and 12 months did not differ significantly. For differentiation of physiologic murmurs from murmurs caused by mild AS, duration of murmur frequency > 200 Hz was useful and the combination assessment of duration of frequency > 200 Hz and T(2) of the murmur had a sensitivity of 94% and a specificity of 82%. Maximal murmur frequency did not differentiate dogs with AS from those without AS.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that assessment of the duration of murmur frequency > 200 Hz can be used to distinguish physiologic heart murmurs from murmurs caused by mild AS in Boxers. Combination of this analysis with T(2) analysis may be a useful complementary method for diagnostic assessment of cardiovascular function in dogs.
Topics: Animals; Aortic Valve Stenosis; Data Interpretation, Statistical; Dog Diseases; Dogs; Echocardiography, Doppler, Color; Female; Heart Auscultation; Heart Murmurs; Male
PubMed: 17764410
DOI: 10.2460/ajvr.68.9.962 -
Computers in Biology and Medicine Sep 2013Early detection of coronary artery disease (CAD) using the acoustic approach, a noninvasive and cost-effective method, would greatly improve the outcome of CAD patients.... (Comparative Study)
Comparative Study Randomized Controlled Trial
Early detection of coronary artery disease (CAD) using the acoustic approach, a noninvasive and cost-effective method, would greatly improve the outcome of CAD patients. To detect CAD, we analyze diastolic sounds for possible CAD murmurs. We observed diastolic sounds to exhibit 1/f structure and developed a new method, path length entropy (PLE) and a scaled version (SPLE), to characterize this structure to improve CAD detection. We compare SPLE results to Hurst exponent, Sample entropy and Multiscale entropy for distinguishing between normal and CAD patients. SPLE achieved a sensitivity-specificity of 80%-81%, the best of the tested methods. However, PLE and SPLE are not sufficient to prove nonlinearity, and evaluation using surrogate data suggests that our cardiovascular sound recordings do not contain significant nonlinear properties.
Topics: Aged; Coronary Artery Disease; Diastole; Entropy; Female; Heart Sounds; Humans; Male; Middle Aged; Signal Processing, Computer-Assisted
PubMed: 23930808
DOI: 10.1016/j.compbiomed.2013.05.018 -
Bosnian Journal of Basic Medical... Aug 2005Innocent heart murmurs are hearth murmurs that occur in patients with a normal heart structure. They do not represent a disease of the heart and vascular system, and...
Innocent heart murmurs are hearth murmurs that occur in patients with a normal heart structure. They do not represent a disease of the heart and vascular system, and should not be treated as such. Iron-deficiency anaemia often causes, along with other symptoms, systolic heart murmurs and tachycardia. It appears in children of all ages representing a most common haematological paediatric disease. To establish the influence of iron-deficiency anaemia on genesis of innocent murmurs and to compare auscultatory and phono-electrocardiographic findings in patients with anaemia and heart murmurs before and after iron therapy. The study includes 120 patients with innocent heart murmurs that have been auscultated at cardio-rheumatic outpatient department of Pediatric Clinic of the Clinical Center of the University of Sarajevo, during the period from 01/01/2004 to 31/12/2004. Further diagnostic procedure, i.e. laboratory tests, diagnosed iron-deficiency anaemia in 30/120 patients. These patients have been followed in this study. 22/30 patients had systolic murmur I/II intensity of Levin scale; 8/30 patients had II/VI systolic murmurs of intensity by Levin. The highest number of examinees had 0-1 years of age, and in this group the number of boys was higher than the number of girls (M: F = 12:4). During the auscultatory and phono-ECG examinations of murmurs, 6 patients had haemoglobin values less than 95 g/l, which corresponds to an average and severe type of anaemia. 24 patients had haemoglobin values between 95 and 110 g/l, which corresponds to benign type of anaemia. The most numerous were patients aged between 0 - 1 year (3 patients with hemoglobin value Hb < 95 g/l, 13 patients with hemoglobin value Hb 95-110 g/l). All patients were treated with iron medicaments. After three months, clinical and laboratory re-evaluation was performed and it has demonstrated that after iron therapy 24 patients had level of a haemoglobin Hb >110 g/l and 6 patients had haemoglobin levels between 95 and 110 g/l. By auscultatory and phono-ECG examinations, murmurs of a level of intensity I/II was registered in only one child, while in the other 29 patients there were not any registered heart murmurs. Diagnosis of anaemia in the paediatric population group delays definitive diagnosis of heart murmurs. Innocent murmurs in children with sideropenic anaemia occur as its consequence. After adequately conducted iron therapy, i.e. cured anaemia, heart murmurs were not auscultated.
Topics: Adolescent; Anemia, Iron-Deficiency; Child; Child, Preschool; Female; Heart Auscultation; Heart Murmurs; Hematinics; Hemoglobins; Humans; Infant; Iron; Male; Phonocardiography
PubMed: 16351580
DOI: 10.17305/bjbms.2005.3269 -
The American Journal of Case Reports Mar 2022BACKGROUND This report presents a rare case of a traumatic innominate artery to left innominate vein fistula following a stab wound to the base of the neck. CASE REPORT...
BACKGROUND This report presents a rare case of a traumatic innominate artery to left innominate vein fistula following a stab wound to the base of the neck. CASE REPORT We report a case of a 23-year-old patient with a traumatic innominate-innominate arteriovenous fistula, after being stabbed in the suprasternal notch area 3 years prior. The patient presented with fatigue, and shortness of breath on exertion. Examination revealed a wide pulse pressure, bounding pulses, and a continuous murmur on the upper sternal area. Chest X-rays, echocardiography, CT angiography, and cardiac catheterization were useful to aid in diagnosis and work-up for fistula repair. A complex 8-mm fistula between the left innominate vein and the proximal innominate artery was noted, with multiple tortuous channels and demonstrating a reversible left-to-right shunt. After medical optimization, successful surgical ligation and division of the fistula was done through median sternotomy without cardiopulmonary bypass. The postoperative recovery was uneventful. CONCLUSIONS Traumatic innominate-innominate arteriovenous fistulas are rare and can pose a diagnostic challenge. High index of suspicion, careful history, examination, and radiologic evaluation usually result in correct diagnosis. Endovascular and surgical approaches are the mainstay treatment.
Topics: Adult; Arteriovenous Fistula; Brachiocephalic Veins; Computed Tomography Angiography; Heart Murmurs; Humans; Wounds, Stab; Young Adult
PubMed: 35264551
DOI: 10.12659/AJCR.934270 -
Computers in Biology and Medicine Apr 2016A phonocardiogram (PCG) signal can be recorded for long-term heart monitoring. A huge amount of data is produced if the time of a recording is as long as days or weeks....
BACKGROUND
A phonocardiogram (PCG) signal can be recorded for long-term heart monitoring. A huge amount of data is produced if the time of a recording is as long as days or weeks. It is necessary to compress the PCG signal to reduce storage space in a record and play system. In another situation, the PCG signal is transmitted to a remote health care center for automatic analysis in telemedicine. Compression of the PCG signal in that situation is necessary as a means for reducing the amount of data to be transmitted. Since heart beats are of a cyclical nature, compression can make use of the similarities in adjacent cycles by eliminating repetitive elements as redundant. This study proposes a new compression method that takes advantage of these repetitions.
METHODS
Data compression proceeds in two stages, a training stage followed by the compression as such. In the training stage, a section of the PCG signal is selected and its sounds and murmurs (if any) decomposed into time-frequency components. Basic components are extracted from these by clustering and collected to form a dictionary that allows the generative reconstruction and retrieval of any heart sound or murmur. In the compression stage, the heart sounds and murmurs are reconstructed from the basic components stored in the dictionary. Compression is made possible because only the times of occurrence and the dictionary indices of the basic components need to be stored, which greatly reduces the number of bits required to represent heart sounds and murmurs. The residual that cannot be reconstructed in this manner appears as a random sequence and is further compressed by vector quantization. What we propose are quick search parameters for this vector quantization.
RESULTS
For normal PCG signals the compression ratio ranges from 20 to 149, for signals with median murmurs it ranges from 14 to 35, and for those with heavy murmurs, from 8 to 20, subject to a degree of distortion of ~5% (in percent root-mean-square difference) and a sampling frequency of 4kHz.
DISCUSSION
We discuss the selection of the training signal and the contribution of vector quantization. Performance comparisons between the method proposed in this study and existing methods are conducted by computer simulations.
CONCLUSIONS
When recording and compressing cyclical sounds, any repetitive components can be removed as redundant. The redundancies in the residual can be reduced by vector quantization. The method proposed in this study achieves a better performance than existing methods.
Topics: Heart Murmurs; Phonocardiography; Signal Processing, Computer-Assisted; Smartphone; Sound; Telemedicine
PubMed: 26871603
DOI: 10.1016/j.compbiomed.2016.01.017 -
Journal of Veterinary Internal Medicine 2003Twenty students and 16 diplomates listened to 7 recordings made from 7 horses with either aortic (n = 3) or mitral valve (n = 4) regurgitant murmurs. A total of 30...
An assessment of the terminology used by diplomates and students to describe the character of equine mitral and aortic valve regurgitant murmurs: correlations with the physical properties of the sounds.
Twenty students and 16 diplomates listened to 7 recordings made from 7 horses with either aortic (n = 3) or mitral valve (n = 4) regurgitant murmurs. A total of 30 different terms were used to describe the character of these murmurs. However, only 4 terms were used in a repeatable and consistent manner. Most people described the character of a given mitral or aortic valve murmur with 1 or 2 terms. Diplomates drew from a pool of terms that was about half the size of that used by students--8.1 +/- 2.0 terms for diplomats (mean +/- 1 SD) versus 13.1 +/- 1.8 terms for students (P > .001). Only blowing, honking, buzzing, and musical were markedly associated with the recording played. Frequency analysis of the murmurs allowed them to be classified as containing harmonics (n = 4) or not containing harmonics (n = 3). Blowing was used to describe murmurs without harmonics on 39 of 48 occasions and corresponds to the term noisy used in some older descriptions of equine murmurs. Honking, musical, and buzzing were markedly associated with murmurs that contained harmonics; these terms were used 23, 13, and 12 of a possible 64 times, respectively. The frequency of buzzing and honking murmurs (72.7 +/- 9.3 and 88.4 +/- 46.3 Hz, respectively) was markedly lower than that of musical murmurs (156.8 +/- 81.1 Hz) (all P values < .01). Honking murmurs (0.392 +/- 0.092 seconds) were shorter than those described as buzzing or musical (0.496 +/- 0.205 and 0.504 +/- 0.116 seconds, respectively). The data suggest that the terminology for the character of aortic and mitral regurgitant murmurs should be restricted to 4 terms: blowing, honking, buzzing, and musical. Honking, buzzing, and musical describe murmurs with a peak dominant frequency and harmonics; blowing describes murmurs without a peak frequency. Effective communication could be enhanced by playing examples of reference sounds when these terms are taught so that nomenclature is used more uniformly.
Topics: Animals; Aortic Valve; Education, Veterinary; Heart Auscultation; Heart Murmurs; Heart Sounds; Horse Diseases; Horses; Mitral Valve; Students; Terminology as Topic; Veterinarians
PubMed: 12774975
DOI: 10.1111/j.1939-1676.2003.tb02457.x -
Revista Portuguesa de Cardiologia :... Jun 2008Innocent heart murmur is a frequent auscultatory finding in children. The diagnosis is essentially clinical, without need for further investigation. However, excluding... (Review)
Review
Innocent heart murmur is a frequent auscultatory finding in children. The diagnosis is essentially clinical, without need for further investigation. However, excluding heart disease can be a difficult task. This review article describes some features of medical history and physical examination that help in this differentiation. The role of diagnostic tests is also examined.
Topics: Child; Heart Murmurs; Humans; Physical Examination
PubMed: 18751509
DOI: No ID Found -
Journal of the American Veterinary... Nov 2012To determine the prevalence of heart murmurs in chinchillas (Chinchilla lanigera) and determine whether heart murmurs were associated with cardiac disease.
OBJECTIVE
To determine the prevalence of heart murmurs in chinchillas (Chinchilla lanigera) and determine whether heart murmurs were associated with cardiac disease.
DESIGN
Retrospective multi-institutional case series.
ANIMALS
260 chinchillas.
PROCEDURES
Medical records of all chinchilla patients evaluated at the Tufts University Foster Hospital for Small Animals between 2001 and 2009, the University of California-Davis William R. Pritchard Veterinary Medical Teaching Hospital between 1996 and 2009, and the University of Wisconsin Veterinary Medical Teaching Hospital between 1998 and 2009 were reviewed.
RESULTS
Prevalence of heart murmurs was 23% (59/260). Of 15 chinchillas with heart murmurs that underwent echocardiography, 8 had echocardiographic abnormalities, including dynamic right ventricular outflow tract obstruction, mitral regurgitation, hypertrophy of the left ventricle, tricuspid regurgitation, and hypovolemia. Echocardiographic abnormalities were approximately 29 times as likely (OR, 28.7) to be present in chinchillas with a murmur of grade 3 or higher than in chinchillas without a murmur.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that heart murmurs are common in chinchillas and that chinchillas with heart murmurs often have echocardiographic abnormalities, with valvular disease being the most common. On the basis of these results, we believe that echocardiography should be recommended for chinchillas with heart murmurs, especially older chinchillas with murmurs of grade 3 or higher. Further prospective studies are needed to accurately evaluate the prevalence of cardiac disease in chinchillas with heart murmurs.
Topics: Animals; Chinchilla; Female; Heart Murmurs; Male; Odds Ratio; Retrospective Studies
PubMed: 23113527
DOI: 10.2460/javma.241.10.1344 -
Journal of Cardiology Jan 2015Right ventricular outflow tract (RVOT) stenosis and pulmonary regurgitation (PR) are important residua and sequelae in adult tetralogy of Fallot (TOF) patients.... (Comparative Study)
Comparative Study
BACKGROUND
Right ventricular outflow tract (RVOT) stenosis and pulmonary regurgitation (PR) are important residua and sequelae in adult tetralogy of Fallot (TOF) patients. Auscultation of the heart sound is a useful tool to detect and evaluate these lesions, but there was no previous report regarding heart sound in adult TOF.
METHODS
We enrolled consecutive TOF outpatients from January 2013 to October 2013 in our adult congenital heart disease clinic. Phonocardiogram with phono-recording was performed with MES-1000 (Fukuda-Denshi Co., Tokyo, Japan), and compared heart sound with echocardiographic parameters.
RESULTS
A total of 30 TOF patients were enrolled [age, 34.7±12.8 years; 14 males (46.7%)]. In all 30 patients, phonocardiography was clearly recorded. Eighteen patients (60.0%) had the single second heart sound, which was more frequently observed before than after pulmonary valve reoperation (75.0% vs 11.1%). The single second heart sound was also associated with PR. In 18/30 (60%), diastolic murmur was associated with moderate PR (p=0.008). In 14/30 (46.7%), systolic murmur was associated with moderate RVOT stenosis (p=0.012).
CONCLUSION
Phonocardiogram was a useful tool to detect RVOT lesions. We should listen to heart sound carefully especially focusing on the second heart sound, systolic, and diastolic murmur.
Topics: Adolescent; Adult; Diastole; Female; Heart Murmurs; Heart Sounds; Humans; Male; Middle Aged; Phonocardiography; Pulmonary Valve Insufficiency; Severity of Illness Index; Systole; Tetralogy of Fallot; Ventricular Outflow Obstruction; Young Adult
PubMed: 24842232
DOI: 10.1016/j.jjcc.2014.03.011 -
The Journal of Veterinary Medical... Jun 2010Seven hundreds fifty-two Standardbreds, with poor performance, underwent a thorough diagnostic protocol. In 157 out of 233 horses, with cardiac murmurs, echocardiography...
Seven hundreds fifty-two Standardbreds, with poor performance, underwent a thorough diagnostic protocol. In 157 out of 233 horses, with cardiac murmurs, echocardiography and color flow Doppler (CFD) mapping were performed. Murmur of tricuspid valve regurgitation was identified in 185 horses, while murmurs of mitral (23), aortic (9) and pulmonary (3) valve regurgitations were detected less frequently. Functional systolic, functional pre-systolic, and functional early diastolic murmurs were identified in 10, 11 and 2 horses. Two-dimensional and M-mode echocardiography showed no abnormality in 145 horses and by CFD the presence of one or more jets of valve regurgitation were observed in 149 patients. The results obtained suggest that cardiac murmurs are a common finding in Standardbreds presented with poor performance.
Topics: Animals; Aortic Valve Insufficiency; Diastole; Echocardiography; Echocardiography, Doppler, Color; Heart Murmurs; Horse Diseases; Horses; Mitral Valve Insufficiency; Physical Examination; Prevalence; Running; Systole; Tricuspid Valve Insufficiency
PubMed: 20110625
DOI: 10.1292/jvms.09-0217