Soft murmur that is audible with careful auscultation Very soft murmur that is not immediately audible but can be heard only after careful auscultation in a quiet environment For example, a dynamic grade I–III/VI murmur describes a murmur that has an intensity that varies throughout the auscultation period, from difficult to hear (grade I) to immediately identifiable (grade III). 1 If murmur grade varies, as it often does in cats, the term "dynamic" is used and the grade is given as a range. Murmur intensity or "grade" is defined below. Intensity refers to the loudness of a murmur. When attributable to cardiac disease, murmur characteristics reflect which underlying cardiac disease may be present.ġ. Accurate description of a heart murmur facilitates determination of its possible genesis, whether it be physiologic or attributable to cardiac disease. Heart murmurs are routinely described by 1) intensity (loudness) 2) timing in the cardiac cycle and 3) location. In some cases, turbulent blood flow not only produces a heart murmur, but also a thrill that is palpable on the chest wall. When heart disease produces a heart murmur, it is because dynamic or fixed pathology disturbs laminar blood flow and creates turbulence. 1 In a normal heart, blood flow is characteristically laminar and hence silent. Third and fourth heart sounds should not be appreciated in a normal dog or cat.Ī heart murmur is defined as a prolonged series of auditory vibrations emanating from the heart or blood vessels, most commonly attributable to turbulent blood flow. The second heart sound (S2) is audible at the completion of ventricular systole and is attributable to closure of the aortic and pulmonic valves. The first heart sound (S1) is attributable to closure of the mitral and tricuspid valves at the onset of systole. In a normal dog or cat, two heart sounds are audible. All rights reserved.Physical examination of the cat or dog with suspected heart disease provides valuable information that allows "short-listing" of differential diagnoses to facilitate appropriate diagnostic and treatment recommendations. In conclusion, LVCD, whether LBBB or L-IVCD, was strongly associated with increased mortality in patients with and at-risk for CVD.Ĭopyright © 2019 Elsevier Inc. After adjustment, LBBB and L-IVCD were similarly associated with increased all-cause (LBBB: 2.3, p = 0.001 L-IVCD: 4.0, p 120 ms) and CVD status. Study patients were 63 ± 9 years, 64% female, 75% Caucasian, 23% with established CVD. Of 24,081 patients randomized, 22,067 (92%) were included with follow-up 34 ± 13 months. The primary outcome was adjudicated all-cause and cardiovascular (CV) mortality. IVCD was subclassified if left ventricular conduction delay (LVCD) was present (L-IVCD) or absent (O-IVCD). QRS duration was classified narrow (≤100 ms) versus prolonged (>100 ms) with additional categorization into left (LBBB) or right (RBBB) bundle branch block or nonspecific intraventricular conduction delay (IVCD). Patients with centrally adjudicated, nonpaced baseline ECGs were included. A post-hoc analysis was performed of the randomized-control PRECISION trial. We aimed to compare clinical outcomes of narrow versus prolonged intraventricular conduction on ECG stratified by QRS morphology and cardiovascular disease (CVD) status. The prognosis associated with prolonged intraventricular conduction on electrocardiogram (ECG) remains uncertain.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |