Identification and Clinical Significance of Heart Murmurs in Puppies Involved in Puppy Trade
Abstract
:1. Introduction
2. Clinical Examination of the Cardiovascular System
2.1. Innocent Heart Murmur
2.2. Functional Heart Murmur
2.3. Pathological Heart Murmur
3. Common Congenital Heart Abnormalities
3.1. Pulmonary Stenosis
- Type 1: Dysplasia only affects the valve leaflets, which are fused together but have some mobility, showing a systolic dooming on echocardiographic examination. The aortic/pulmonary trunk diameter ratio is, however, maintained [26].
- Type 2: In addition to dysplasia of the pulmonary valve leaflets as in type 1, there is a hypoplasia of the valve annulus with a diameter ratio between the aorta and the pulmonary trunk greater than 1.5 [26].
3.2. Patent Ductus Arteriosus
3.3. Subaortic Stenosis and Aortic Stenosis
- -
- First degree: Small subvalvular endocardial nodules of a few millimetres forming a limited narrowing. There may be no heart murmur at this stage.
- -
- Second degree: The endocardial thickening increases, there is a narrow fibrotic ridge that extends around the left ventricular outflow tract.
- -
- Third degree: Subvalvular obstruction becomes a fibromuscular tunnel involving a large portion of the left ventricle outflow tract and also the mitral valve apparatus.
3.4. Ventricular Septal Defect and Atrial Septal Defect
3.5. Tricuspid Valve Dysplasia and Mitral Valve Dysplasia
3.6. Tetrology of Fallot
- -
- PS: With both infundibular and valvular components, often associated with pulmonary trunk hypoplasia.
- -
- Concentric right ventricular hypertrophy: Secondary to the pressure overload due to PS.
- -
- VSD: Generally large, it allows a right-left shunt due to the high resistance of the pulmonary circulation.
- -
- Dextropositioned aorta [51].
Cardiac Heart Defect | Breed Predisposition | Murmur Decsription | References |
---|---|---|---|
Pulmonary Stenosis | bulldogs and boxers | Holosystolic, with rough timbre and PMI on the pulmonary valve focus, poorly or non-radiated, with a “crescendo-decrescendo” pattern | [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29] |
Patent ductus arteriosus | poodle, German shepherd dog, Pomeranian, Shetland sheep dog, collie, Maltese, Yorkshire terrier, chihuahua and Stabyhoun | Continuous (Gibson’s murmur), located in the left axillary region, with intensity ranged between IV/VI and VI/VI degrees. | [13,14,15,16,17,18,19,21,30,31,32,33,34,35,36,37,38] |
Subaortic Stenosis | Large-breed dogs, such as the rottweiler, golden retriever and boxer | Holosystolic, “crescendo-decrescendo”, with a rough timbre, located at the focus of the aortic valve, can irradiate. | [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,39,40] |
Aortic Stenosis | Large-breed dogs, such as the rottweiler, golden retriever and boxer | Holosystolic, “crescendo-decrescendo”, with a rough timbre, located at the focus of the aortic valve. | [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,39,40] |
Ventricular Septal Defect | No breed predisposition has been reported | Holosystolic, II–III degree with PMI over the right heart base. A split S2 heart sound may be present. | [13,14,15,16,17,18,19,21,29,41,42,43] |
Atrial Septal Defect | boxer, doberman, old English sheep dog and Samoyed | Holosystolic, II–III degree with PMI over the right heart base. A split S2 heart sound may be present. | [13,14,15,16,17,18,19,21,41,42,43] |
Tricuspid valve dysplasia | Dogues de Bordeaux | “Plateau” murmur holosystolic or pansystolic, with PMI at the focus of tricuspid auscultation | [21,44,45,46,47,48] |
Mitral valve dysplasia. | bull terrier and Great Dane | “Plateau” murmur holosystolic or pansystolic type, with PMI at the focus of mitral auscultation | [21,44,45,46,47,48] |
Tetrology of Fallot | Keeshond | Depending to PS degree:loud right basilar holosystolic in presence of mild PS and a small VSD;absence in presence of severe PS and a large VSD. | [13,14,15,16,17,18,19,21,49,50,51,52] |
4. Discussion
- 1.
- Pre-existing or have a pre-existing cause;
- 2.
- Hidden (that is, it cannot be revealed during a routinary examination) or not easily recognized (at the time of purchase, it cannot be identified using the usual due diligence);
- 3.
- Serious or chronic: The defect, in relation its severity, renders the puppy unsuitable for the usage for which it is acquired, to such an extent that the buyer would not have bought it or would have given a lower price if he had been conscious of that.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Heart Murmur Grade | Description |
---|---|
GRADE 1 | Very light murmur, difficult to hear, well localized. |
GRADE 2 | Light murmur but easy to recognize when the PMI is located. |
GRADE 3 | Modest murmur which has an intensity equivalent to normal heart sounds. |
GRADE 4 | Strong murmur but no palpable thrill. |
GRADE 5 | Strong murmur with palpable precordial thrill. |
GRADE 6 | Strong murmur with palpable thrill, even without the stethoscope. |
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Pugliese, M.; Biondi, V.; La Maestra, R.; Passantino, A. Identification and Clinical Significance of Heart Murmurs in Puppies Involved in Puppy Trade. Vet. Sci. 2021, 8, 139. https://doi.org/10.3390/vetsci8080139
Pugliese M, Biondi V, La Maestra R, Passantino A. Identification and Clinical Significance of Heart Murmurs in Puppies Involved in Puppy Trade. Veterinary Sciences. 2021; 8(8):139. https://doi.org/10.3390/vetsci8080139
Chicago/Turabian StylePugliese, Michela, Vito Biondi, Rocky La Maestra, and Annamaria Passantino. 2021. "Identification and Clinical Significance of Heart Murmurs in Puppies Involved in Puppy Trade" Veterinary Sciences 8, no. 8: 139. https://doi.org/10.3390/vetsci8080139