Murmur intensity in adult dogs with pulmonic and subaortic stenosis reflects disease severity

ObjectivesThe aims of this study were to determine whether murmur intensity in adult dogs with pulmonic stenosis or subaortic stenosis reflects echocardiographic disease severity and to determine whether a six‐level murmur grading scheme provides clinical advantages over a four‐level scheme.
Materials and MethodsIn this retrospective multi‐investigator study on adult dogs with pulmonic stenosis or subaortic stenosis, murmur intensity was compared to echocardiographically determined pressure gradient across the affected valve. Disease severity, based on pressure gradients, was assessed between sequential murmur grades to identify redundancy in classification. A simplified four‐level murmur intensity classification scheme (‘soft’, ‘moderate’, ‘loud’, ‘palpable’) was evaluated.
ResultsIn total, 284 dogs (153 with pulmonic stenosis, 131 with subaortic stenosis) were included; 55 dogs had soft, 59 had moderate, 72 had loud and 98 had palpable murmurs. 95 dogs had mild stenosis, 46 had moderate stenosis, and 143 had severe stenosis. No dogs with soft murmurs of either pulmonic or subaortic stenosis had transvalvular pressure gradients greater than 50 mmHg. Dogs with loud or palpable murmurs mostly, but not always, had severe stenosis. Stenosis severity increased with increasing murmur intensity. The traditional six‐level murmur grading scheme provided no additional clinical information than the four‐level descriptive murmur grading scheme.
Clinical Signi...

Source: The Journal of Small Animal Practice - October 11, 2017 Category: Veterinary Research Authors: D. Caivano, D. Dickson, M. Martin, M. Rishniw Tags: PAPER Source Type: research