References

Gompf RE The history of physical examination, 5th edn. In: Smith FWK, Tilley LP, Oyama MA, Sleeper MM (eds). Missouri: Elsevier; 2015

Höglund K, French A, Dukes-McEwan J Low intensity heart murmurs in boxer dogs: inter-observer variation and effects of stress testing. J Small Anim Pract. 2004; 45:(4)178-85

Kvart C Clinical approach to cardiac murmurs, 2nd edn. In: Luis Fuentes V, Johnson LR, Dennis S (eds). Gloucester: BSAVA; 2010

LLópez-Alvarez J, Elliott J, Pfeiffer D Clinical severity score system in dogs with degenerative mitral valve disease. J Vet Intern Med. 2015; 29:(2)575-81 https://doi.org/https://doi.org/10.1111/jvim.12544

Naylor JM, Yadernuk LM, Pharr JW, Ashburner JS An assessment of the ability of diplomates, practitioners, and students to describe and interpret recordings of heart murmurs and arrhythmia. J Vet Intern Med. 2001; 15:(6)507-15

Payne J, Luis Fuentes V, Boswood A, Connolly D, Koffas H, Brodbelt D Population characteristics and survival in 127 referred cats with hypertrophic cardiomyopathy (1997 to 2005). J Small Anim Pract. 2010; 51:(10)540-7 https://doi.org/https://doi.org/10.1111/j.1748-5827.2010.00989.x

Pedersen HD, ggström J, Falk T Auscultation in mild mitral regurgitation in dogs: observer variation, effects of physical maneuvers, and agreement with color Doppler echocardiography and phonocardiography. J Vet Intern Med. 1999; 13:(1)56-64

Wagner T, Fuentes VL, Payne JR, McDermott N, Brodbelt D Comparison of auscultatory and echocardiographic findings in healthy adult cats. J Vet Cardiol. 2010; 12:(3)171-82 https://doi.org/https://doi.org/10.1016/j.jvc.2010.05.003

Ware W Cardiovascular Disease in Small Animal Medicine.London: Manson Publishing; 2007

How to maximise your auscultation technique

02 November 2017
8 mins read
Volume 8 · Issue 9

Abstract

Auscultation is a cheap and easy diagnostic tool available in veterinary practice. Yet it often creates uncertainty, prompting both nurses and veterinary surgeons to seek second opinions amongst colleagues. The purpose of this article is to explore the best techniques for auscultation, and discuss the different sounds that can be heard in dogs and cats when listening to the heart. The starting point of auscultation is to identify normal heart sounds. This will then help recognise abnormal heart sounds, which can then be split into loudness, timing, and point of maximal intensity.

Auscultation is a cheap and easy diagnostic tool available in every veterinary practice. Yet if we ask ourselves if it is used to its full potential, the answer is probably no. While it seems like an easy enough task to perform, it is frequently over complicated. Two things hinder auscultation technique. First, optimal listening conditions are rarely achieved; and second, cardiologists agree that recognising abnormal heart sounds, and gaining proficiency in the technique is difficult (Pedersen et al, 1999; Naylor et al, 2001; Ware, 2007).

Primarily, auscultation of the heart is used to record heart rate and rhythm, and to determine heart sounds. As with most things in life, practice is key, so that abnormal sounds can be readily distinguished from normal heart sounds. If abnormal sounds are heard, it is recommended to determine the timing of the additional sounds, the point of maximal intensity (PMI) — or where the sound is heard the loudest — and finally, the intensity or loudness of the sounds in relation to a grading system.

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