Age when presumptive innocent cardiac murmurs spontaneously disappear in clinically healthy Cairn terrier puppies

Staveren, M. D.B. van; Szatmári, Viktor

doi:10.1016/j.tvjl.2019.04.002

Cited by 5 publications

(17 citation statements)

References 10 publications

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“…This assumption is supported by the fact that the prevalence of soft cardiac murmurs in the population of the present study (29%) was comparable to the prevalence of innocent murmurs of our earlier studies (28% and 31%) performed on populations with very similar characteristics [2,3]. Moreover, 20 Cairn terriers from the present cross-sectional study participated in a longitudinal study where they were followed up at approximately monthly intervals [4]. The murmurs in all 20 puppies disappeared spontaneously [4].…”

Section: Discussionsupporting

confidence: 88%

“…The murmurs in the present study were presumed to be non-pathologic, however no additional tests, such as echocardiograms, were performed to establish the origin of the murmurs, as it was not an aim of the study. Based on human studies and our previous studies, all murmurs in the presented group were thought to be innocent [1][2][3][4][5][6]. This assumption is supported by the fact that the prevalence of soft cardiac murmurs in the population of the present study (29%) was comparable to the prevalence of innocent murmurs of our earlier studies (28% and 31%) performed on populations with very similar characteristics [2,3].…”

Section: Discussionsupporting

confidence: 84%

“…When a murmur was detected, its intensity (on a scale of 1-6, with 1 being the softest), the point of maximal intensity (left or right cardiac base or apex), the timing (systolic and/or diastolic, or continuous) and its additional character, such as musical or intermittently audible, were described [1,2]. A murmur was classified as grade 1, if it was very soft, focal and was heard only after several seconds of careful auscultation; while a murmur was classified as grade 2 if it was soft, focal, but was heard immediately [1][2][3][4]. A murmur was defined as intermittent if a soft (1 or 2 out of 6) murmur was heard for the first time on the left hemithorax, but either it disappeared while the auscultation was still ongoing on the same anatomical location or it could not be identified when the left hemithorax was auscultated again [2][3][4].…”

Section: Auscultationmentioning

confidence: 99%

“…A murmur was classified as grade 1, if it was very soft, focal and was heard only after several seconds of careful auscultation; while a murmur was classified as grade 2 if it was soft, focal, but was heard immediately [1][2][3][4]. A murmur was defined as intermittent if a soft (1 or 2 out of 6) murmur was heard for the first time on the left hemithorax, but either it disappeared while the auscultation was still ongoing on the same anatomical location or it could not be identified when the left hemithorax was auscultated again [2][3][4]. Musical character of the murmur was defined as a soft, low-to medium-pitched vibrating sound [2,5].…”

Section: Auscultationmentioning

confidence: 99%

“…in the absence of structural cardiovascular anomalies, which in puppies and children tend to disappear spontaneously with age [1][2][3][4][5][6]. Pathological murmurs in puppies, however, are caused by structural cardiovascular lesions, most likely due to congenital cardiac anomalies [1,7].…”

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confidence: 99%

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Detecting and recording cardiac murmurs in clinically healthy puppies in first opinion veterinary practice at the first health check

Staveren

Szatmári

2020

Acta Vet Scand

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Background: The frequency that cardiac murmurs are identified and recorded in first opinion veterinary practices at the first health check in puppies is unknown. The aims of the study were to assess the agreement between first opinion veterinary practitioners, a veterinary student and a veterinary cardiology specialist on detecting murmurs, and to establish whether abnormal auscultation findings had been recorded in the health certificates of clinically healthy puppies. The study included prospective and retrospective investigations, where the prospectively collected auscultation findings from a veterinary cardiology specialist and a trained veterinary student were compared to auscultation findings recorded by first opinion veterinary practitioners. Results: Cardiac auscultation was performed on 331 client-owned, clinically healthy dogs at two time points: at age 34-69 days by a first opinion veterinary practitioner and at age 45-76 days, on average 9 days later, by a veterinary cardiology specialist and a trained veterinary student. Agreement among the three was compared for the presence of a murmur. The degree of inter-observer agreement was evaluated using Cohen's kappa. Auscultation findings, as noted in the pets' passports, from 331 puppies and 43 different first opinion veterinary practices, were retrospectively reviewed and prospectively compared with auscultation findings from a veterinary cardiology specialist. Agreement between the veterinary cardiology specialist and the first opinion veterinary practitioners was poor (ϰ = 0.01) and significantly different (P < 0.001). First opinion veterinary practitioners had recorded a cardiac murmur in only 1 of the 97 puppies in which the veterinary cardiology specialist detected a murmur. Two-hundred-and-fifty-two puppies were auscultated by both the veterinary cardiology specialist and the student. Their agreement was fair (ϰ = 0.40) and significantly different (P = 0.024). The agreement between the student and a first opinion veterinary practitioner on these 252 puppies was poor (ϰ = 0.03) and significantly different (P < 0.001). Conclusions: This study shows that soft cardiac murmurs are rarely documented during the first veterinary health check in puppies by first opinion veterinary practitioners. Although soft murmurs may not be clinically relevant, finding and recording them is evidence of a carefully performed auscultation. Missing a non-pathological murmur is not of clinical importance; however, missing a pathological murmur could prove detrimental for the individual puppy.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

Section: Auscultationmentioning

confidence: 99%

Section: Auscultationmentioning

confidence: 99%

mentioning

confidence: 99%

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Detecting and recording cardiac murmurs in clinically healthy puppies in first opinion veterinary practice at the first health check

Staveren

Szatmári

2020

Acta Vet Scand

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Temporal changes in the presence and intensity of innocent cardiac murmurs in clinically healthy Cairn terrier and Dachshund puppies between 4 and 8 weeks of age

2021

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Background: Spontaneous week-to-week variation in the presence and intensity of innocent cardiac murmurs in individual puppies is unknown. Methods: Sixty privately owned, clinically healthy Cairn terrier and Dachshund puppies between 4 and 8 weeks of age were included. All dogs underwent weekly cardiac auscultation at the breeders' home by a veterinary cardiology specialist using an acoustic stethoscope. On each occasion, a phonocardiogram was recorded with an electronic stethoscope. Furthermore, all dogs were auscultated once at a first opinion veterinary practise and once at the authors' institution, where they also underwent an echocardiographic examination. Results: Two-hundred and eighty-one auscultations were conducted on 32 Cairn terriers and 28 Dachshunds, at the breeders' homes. Innocent murmurs were detected in 19 puppies. Two of these puppies had a detectable murmur on each auscultation. In five of the puppies, the murmur became undetectable during the observation period and in 12 puppies the murmur was intermittently audible. Auscultation at the authors' institution had an unpredictable effect on murmur presence and intensity. Phonocardiography revealed murmurs in 42 puppies. Interpretation of phonocardiograms by two independent observers showed nearly perfect agreement (κ = 0.859). Conclusions: Remarkable and unpredictable spontaneous week-to-week variation was documented in the presence and intensity of innocent murmurs.

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Critically ill neonatal and pediatric patients

McMichael¹,

Gerken²

2023

Small Animal Critical Care Medicine

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Age when presumptive innocent cardiac murmurs spontaneously disappear in clinically healthy Cairn terrier puppies

Cited by 5 publications

References 10 publications

Detecting and recording cardiac murmurs in clinically healthy puppies in first opinion veterinary practice at the first health check

Detecting and recording cardiac murmurs in clinically healthy puppies in first opinion veterinary practice at the first health check

Temporal changes in the presence and intensity of innocent cardiac murmurs in clinically healthy Cairn terrier and Dachshund puppies between 4 and 8 weeks of age

Critically ill neonatal and pediatric patients

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