Heart murmurs in horses: determining their significance with echocardiography.
Abstract: Physiological flow murmurs occur frequently in horses and may be difficult to distinguish from murmurs associated with underlying cardiac disease. The significance of heart murmurs auscultated in horses is often difficult to determine if the horse is not exhibiting any clinical signs or if the signs, such as poor performance, are nonspecific. A complete echocardiographic examination (M-mode, 2-dimensional (2-D) and Doppler) provides an objective assessment of the severity of the horse's underlying cardiac disease. Valvular regurgitation and ventricular septal defects (VSDs) occur frequently and may impair performance, result in the horse's premature demise or have no apparent effect on the horse's life expectancy or performance capabilities. The echocardiographic findings that are used to formulate a prognosis for longevity and performance in horses with valvular regurgitation include the abnormalities detected on the valve leaflets, degree of cardiac chamber enlargement, severity of the resultant volume overload, size of the regurgitant jet, and relative relationship of jet size to chamber size. The echocardiographic findings that are used to formulate a prognosis for horses with VSDs are the number, size and location of the defect(s), degree of left ventricular volume overload, maximal velocity and direction of shunt flow through the defect and the presence and severity of concurrent valvulus regurgitation. Knowledge of the natural progression of the common types of cardiovascular disease in horses, coupled with the echocardiographic findings, clinical history and owner's or trainer's expectations can help the veterinarian form an accurate prognosis for life and performance in horses with heart murmurs.
Publication Date: 1995-09-01 PubMed ID: 8933072DOI: 10.1111/j.2042-3306.1995.tb04992.xGoogle Scholar: Lookup
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Summary
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This study focuses on the use of echocardiography to identify and understand the significance of heart murmurs in horses, exploring the distinctions between normal flow murmurs and those related to cardiac disease, while also discussing prognosis factors.
Context and Focus
- The research establishes the frequent appearances of physiological flow murmurs in horses as an occurrence often difficult to distinguish from murmurs linked to underlying heart diseases.
- The main obstacle lies in determining the significance of these heart murmurs, especially when there are no visible clinical symptoms or when any such signs, like poor performance, are ambiguous.
Echocardiography Application
- The study emphasizes echocardiography as the key diagnostic tool in such situations. The combination of M-mode, 2-dimensional, and Doppler examinations offers an objective perspective on the severity of an equine patient’s underlying heart disease.
- Utilizing echocardiographic results can help veterinarians form an accurate prognosis for life and performance in horses with heart murmurs.
Cardiac Issues Common in Horses
- Two key cardiovascular problems in horses are valvular regurgitation and ventricular septal defects (VSDs). These may affect performance, lead to early mortality, or not noticeably impact the horse’s life expectancy or performance at all.
- Echocardiographic findings form the foundation for prognosis estimates in horses suffering from valvular regurgitation, with key factors being: abnormalities on valve leaflets, cardiac chamber enlargement degree, volume overload severity, size of the regurgitant jet, and relative jet size to chamber size.
- For horses with VSDs, the prognosis is based on: the number, size, and location of defects, degree of left ventricular volume overload, maximum velocity and shunt flow direction through the defect, and presence and severity of concurrent valvulus regurgitation.
Finding and Prognosis
- Through understanding the natural progression of common cardiovascular diseases in horses and interpreting echocardiographic findings in conjunction with clinical history and owner’s or trainer’s expectations, veterinarians can form accurate prognoses.
- This knowledge is crucial for ensuring the health and optimum performance of horses diagnosed with heart murmurs.
Cite This Article
APA
Reef VB.
(1995).
Heart murmurs in horses: determining their significance with echocardiography.
Equine Vet J Suppl(19), 71-80.
https://doi.org/10.1111/j.2042-3306.1995.tb04992.x Publication
Researcher Affiliations
- Department of Clinical Studies (Section of Sports Medicine and Imaging), New Bolton Center, University of Pennsylvania, Kennett Square 19348, USA.
MeSH Terms
- Animals
- Echocardiography / methods
- Echocardiography / veterinary
- Echocardiography, Doppler / methods
- Echocardiography, Doppler / veterinary
- Heart Murmurs / diagnosis
- Heart Murmurs / diagnostic imaging
- Heart Murmurs / veterinary
- Heart Valve Diseases / diagnosis
- Heart Valve Diseases / diagnostic imaging
- Heart Valve Diseases / veterinary
- Heart Valves / diagnostic imaging
- Heart Valves / physiology
- Horse Diseases / diagnosis
- Horse Diseases / diagnostic imaging
- Horse Diseases / physiopathology
- Horses / physiology
- Prognosis
References
This article includes 84 references
Citations
This article has been cited 8 times.- Dufourni A, Buschmann E, Vernemmen I, Van Steenkiste G, van Loon G, Decloedt A. Effect of physiological and pharmacological stress on heart rate, blood pressure, and echocardiographic measurements in healthy Warmblood horses. J Vet Intern Med 2024 Jan-Feb;38(1):398-410.
- Hövener J, Pokar J, Merle R, Gehlen H. Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses. Animals (Basel) 2021 Dec 5;11(12).
- Linnehan BK, Gomez FM, Huston SM, Hsu A, Takeshita R, Colegrove KM, Harms CA, Barratclough A, Deming AC, Rowles TK, Musser WB, Zolman ES, Wells RS, Jensen ED, Schwacke LH, Smith CR. Cardiac assessments of bottlenose dolphins (Tursiops truncatus) in the Northern Gulf of Mexico following exposure to Deepwater Horizon oil. PLoS One 2021;16(12):e0261112.
- Linnehan BK, Hsu A, Gomez FM, Huston SM, Takeshita R, Colegrove KM, Rowles TK, Barratclough A, Musser WB, Harms CA, Cendejas V, Zolman ES, Balmer BC, Townsend FI, Wells RS, Jensen ED, Schwacke LH, Smith CR. Standardization of Dolphin Cardiac Auscultation and Characterization of Heart Murmurs in Managed and Free-Ranging Bottlenose Dolphins (Tursiops truncatus). Front Vet Sci 2020;7:570055.
- Boegli J, Schwarzwald CC, Mitchell KJ. Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation. J Vet Intern Med 2019 May;33(3):1446-1455.
- Seddighi R, Doherty TJ. Anesthesia of the geriatric equine. Vet Med (Auckl) 2012;3:53-64.
- Gunther-Harrington CT, Arthur R, Estell K, Martinez Lopez B, Sinnott A, Ontiveros E, Varga A, Stern JA. Prospective pre- and post-race evaluation of biochemical, electrophysiologic, and echocardiographic indices in 30 racing thoroughbred horses that received furosemide. BMC Vet Res 2018 Jan 18;14(1):18.
- Reef VB, Bonagura J, Buhl R, McGurrin MK, Schwarzwald CC, van Loon G, Young LE. Recommendations for management of equine athletes with cardiovascular abnormalities. J Vet Intern Med 2014 May-Jun;28(3):749-61.
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