Diagnostic Evaluation of Left Apical Systolic Murmur In Dogs
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Date
2024-04-10
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MAFSU, Nagpur
Abstract
The study entitled ‘DIAGNOSTIC EVALUATION OF LEFT
APICAL SYSTOLIC MURMUR IN DOGS’ was carried out at CCDCU, at
Department of Veterinary Medicine, Mumbai Veterinary College, Parel, Mumbai –
400012. Twenty-five dogs, with Left Apical Systolic Murmur and ten apparently
healthy control dogs were included in study. Each dog underwent a thorough
clinical, haemato-biochemical, radiographic, electrocardiographic and
echocardiographic examination.
Predominant clinical signs in study group were Exercise intolerance (40%),
Orthopnoea (23%), Coughing (13%) and Ascites (11%) while 6/25 dogs exhibited
no clinical signs. Significantly higher (p≤0.01) heart rate, respiratory rate and
murmur grade were observed in non-survived group than survived group.
Digital phonocardiogram proved valuable for diagnosing Left Apical
Systolic Murmur, revealing a significant increase (p≤0.01) in the ratio of first (S1)
to second (S2) heart sound in study group. Dogs with severe murmur had a nondiscernible
second heart sound (S2).
Significantly (p≤0.01) lower values of Hb, TEC, PCV and higher TLC,
while significantly low (p≤0.05) albumin were observed in study group than control
group.
VHS and VLAS were significantly increased (p≤0.01) in the study group.
Significantly higher (p≤0.01) VLAS was observed in non-survived dogs than
survived dogs. VLAS had very high positive correlation with LA/Ao (r=0.82) and
RF(r=0.84). VLAS ³2.2-2.4 was found to be a good indicator of LA enlargement.
Predominant electrocardiographic changes observed were significantly
increased P wave duration (p≤0.01) and PR interval (p≤0.05) in the non-survived
group than survived group. On echocardiographic examination, 24/25 dogs reported degenerative
changes of mitral valves. LA/Ao, LVIDdN, LVIDsN, MV E (m/s), MV E/A, RF
and Tei values were significantly higher (p≤0.01) in non-survived group than
survived group. MV E³1.2m/s and RF³50% were found to be good indicators of
severe mitral regurgitation. Tei³0.59 was found to be associated with increased risk
of cardiac death with 92% sensitivity and 75% specificity.