DIAGNOSTIC CARDIOLOGY IN THE EXAM ROOM / Electronic Stethoscope / Cardiac Murmur in the Feline

DIAGNOSTIC CARDIOLOGY IN THE EXAM ROOM

History:

Determine age, breed, and sex of the patient to help formulate a rule-out list and help to determine prognosis. Record current drugs and clinical response. Record  presenting clinical signs.

Physical Examination:

1.    Auscultation, noting:

Heart rate

Presence or absence of the following:

-Heart murmur (Point of maximum intensity, radiation, loudness, timing,  character)

-Gallop sound (rhythm)

-Other abnormality heart sounds (e.g. splitting of S1 or S2, clicks, rubs)

-Arrhythmias

-Abnormal lung sounds

2.    Femoral Pulse palpation (character, rate, rhythm, pulse deficits)

3.    Jugular vein observation for distention or pulsation

4.    Abdominal palpation to assess organomegaly and detect ascites

Electronic Stethoscope:

Electronic stethoscopes have improved dramatically in the past 10 years. In addition to electronic amplification of heart sounds and murmurs, most of the electronic stethoscopes currently allow the user to record and play back sounds at either normal or half speed, a useful feature for judging quality of murmurs and for judging the timing of transient heart sounds such as clicks or gallops. Some models also provide the ability to record graphic representations of sounds in a digital file format (i.e., a phonocardiogram) that can be stored on a computer, possibly even becoming part of the patient’s medical record. A new electronic stethoscope, the 3M Littmann model 3000, features ambient noise reduction circuitry that appears to overcome most if not all of the problems of background noise amplification that plagued previous models.

Cardiac Murmur in the Feline (Diagnosis Based on Age)

Kitten

1.    Congenital (valve dysplasia)

2.    Acquired (anemia 20 and less)

3.    Hypertrophic cardiomyopathy (Maine Coon, Persian)

4.    “Positional” – Innocent

 1-7 Years

1.    Hypertrophic cardiomyopathy

2.    Acquired (anemia, heartworm)

7-14 Years

1.    Hyperthyroidism

2.    Heartworms

3.    Hypertrophic cardiomyopathy

4.    Hypertension

14-20 Years

1.    Valvular fibrosis

2.    Hypertension

3.    Hyperthyroidism

Fonte: CANINE & FELINE Cardiology

             DIAGNOSIS & TREATMENT

             Larry P. Tilley, DVM, DACVIM (Internal Medicine)

             Santa Fe, New Mexico