Getting the most out of your auscultation technique

Dr Luca Ferasin DVM PhD CertVC DipECVIM-CA (Cardiology) MRCVSEuropean and RCVS Specialist in Veterinary Cardiology

HEART AUSCULTATION (Dogs)

Left Base (Aortic & Pulmonic)

Left Apex (Aortic & Pulmonic)

Right Side (Tricuspid)Great Vessels(PDA)

HEART AUSCULTATION (Cats)

Left Parasternal Right Parasternal

Great Vessels(PDA)

Sternal

FastSlow

Gallop Sounds

3rd heart sound (S3) Early diastolic (“passive” diastolic filling)

4th sound (S4) Late diastolic ventricular filling (atrium contraction)

Gallop Sounds

Atrial Fibrillation (chaotic Rhythm)

1 only audible with the absolute concentration

2 soft, but easily heard

3 moderately loud and easily heard

4 loud but does not produce a palpable thrill

5 loud with a palpable thrill

6 very loud (also heard with stethoscope away from the chest)

Heart MurmurGrading (out of 6)

Turbulence originating through narrowed or irregular valves or outflow tracts

Crescendo- decrescendo (diamond-shaped) character

o Aortic or Pulmonic Stenosis

Heart MurmurSystolic diamond-shaped

do to regurgitation or shunts into chambers at lower resistance

o Mitral or Tricuspid valve insufficiencyo Ventricular Septal Defect

Heart Murmur Systolic Plateau Shape

Heart MurmurDiastolic (Rare)

o Aortic regurgitationo (Pulmonic regurgitation)

Constant shunt flow throughout systole and diastole

·Patent Ductus Arteriosus (PDA)·(Systemic or pulmonic A-V fistulas)

Heart MurmurContinuous