Heart Murmurs
Phonocardiography
Physical Examination
Echocardiography
Surgery, Veterinary
Prevalence and clinical significance of cardiac murmurs in neonates. (1/133)
AIM: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination. METHODS: In a two year prospective study, 7204 newborn babies underwent routine examination by senior house officers. All those with murmurs underwent echocardiographic examination. All babies presenting later in infancy were also identified, to ascertain the total prevalence of congenital heart disease in infancy. RESULTS: Murmurs were detected in 46 babies (0.6%) of whom 25 had a cardiac malformation. The most common diagnosis was a ventricular septal defect, although four babies had asymptomatic left heart outflow obstruction. A further 32 infants from the same birth cohort had a normal neonatal examination but were found to have a cardiac malformation before 12 months of age. CONCLUSIONS: The neonatal examination detects only 44% of cardiac malformations which present in infancy. If a murmur is heard there is a 54% chance of there being an underlying cardiac malformation. Parents and professionals should be aware that a normal neonatal examination does not preclude a clinically significant cardiac malformation. The detection of a murmur should prompt early referral to a paediatric cardiologist for diagnosis or appropriate reassurance. (+info)Heart murmurs in pediatric patients: when do you refer? (2/133)
Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonary or aortic outflow tract abnormalities, and patent ductus arteriosus. An atrial septal defect is often confused with a functional murmur, but the conditions can usually be differentiated based on specific physical findings. Characteristics of pathologic murmurs include a sound level of grade 3 or louder, a diastolic murmur or an increase in intensity when the patient is standing. Most children with any of these findings should be referred to a pediatric cardiologist. (+info)Cardiologic evaluation of children with suspected heart disease: experience of a public outpatient clinic in Brazil. (3/133)
CONTEXT: During initial evaluation of children on an outpatient basis, the index of suspected heart disease may be high, particularly if we consider that innocent murmur occurs in about 50% of the pediatric population. This is the most common cause of referral to the pediatric cardiologist. OBJECTIVE: To report on the experience of a public outpatient clinic in the southeastern region of Brazil. DESIGN: Retrospective analysis of all patients submitted to cardiologic evaluation within a 39 month period. SETTING: Public pediatric cardiology outpatient clinic. PARTICIPANTS: 2675 consecutive children aged+info)Apical systolic click and murmur associated with neurofibromatosis. (4/133)
In this report we describe a child who had an apical systolic click and murmur, as well as widespread cutaneous neurofibromatosis. We were not able to show an anatomical basis for the click and murmur. (+info)Accuracy of clinical assessment of heart murmurs by office based (general practice) paediatricians. (5/133)
AIM: To determine the diagnostic accuracy of physical examination by office based (general practice) paediatricians in the evaluation of heart murmurs. DESIGN: Each of 30 office based paediatricians blindly examined a random sample of children with murmurs (43% of which were pathological). Sensitivity and specificity were calculated and were related to paediatricians' characteristics. RESULTS: Mean (SD) sensitivity was 82 (24)% with a mean specificity of 72 (24)% in differentiating pathological from innocent murmurs, with further investigations requested for 54% of assessments. The addition of a referral strategy would have increased mean sensitivity to 87 (20)% and specificity to 98 (8)%. Diagnostic accuracy was not significantly related to the paediatricians' age, education or practice characteristics, but was related to referral practices and confidence in assessment. CONCLUSIONS: Diagnostic accuracy of clinical assessment of heart murmurs by office based paediatricians is suboptimal, and educational strategies are needed to improve accuracy and reduce unnecessary referrals and misdiagnosis. (+info)A 72 year old woman with ALCAPA. (6/133)
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery), which causes the left coronary artery to grow with an anomalous origin from the pulmonary artery, is a rare disease which may result in myocardial infarction, congestive heart failure, and sometimes death during the early infantile period. A 72 year old woman with ALCAPA syndrome is presented. The asymptomatic patient presented with a cardiac murmur which was discovered during a routine check up for a gynaecological intervention. Coronary cineangiography established the diagnosis. Although surgical correction is the usual treatment for such cases, medical treatment was preferred for this patient because she was asymptomatic without clinical signs of heart failure. (+info)Tricuspid aortic valve with partial commissural fusion: prelminary report of an apparently common cause of aortic ejection sounds with potential for serious sequelae, illustrated by two cases. (7/133)
We report the cases of 2 patients whose tricuspid aortic valves were found to have partial commissural fusion. Both patients experienced complications that were probably related to this abnormality: bacterial endocarditis in 1 instance and a lacunar stroke in the other. In order to illustrate the similarity of physical findings, we also describe the case of a 3rd patient, who had a typical bicuspid aortic valve. Tricuspid aortic valve with partial commissural fusion has been described in autopsy series and has been predicted to cause an ejection sound, but we could find no previously published description of this lesion in living patients. We wish to alert others to the possible presence of aortic commissural fusion, to its potential for serious and likely preventable sequelae, and to the ability of carefully performed transthoracic high-resolution digital echocardiography to demonstrate this condition when its characteristics are found on physical examination. (+info)The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. (8/133)
Significant aortic stenosis is prevalent amongst elderly people. It may be subclinical, manifesting only as a murmur, but can still cause unexpected death with little warning after symptoms develop. Recent studies have highlighted the unreliability of the classical clinical signs of severe aortic stenosis, leading to concern that some patients may not be referred appropriately for echocardiography. Here, we review the evidence for the accuracy of each sign. We suggest that the assessment of the patient with a systolic murmur should be reappraised, and offer guidelines toward improving the recognition of aortic stenosis in the community. (+info)A heart murmur is an abnormal sound heard during a heartbeat, which is caused by turbulent blood flow through the heart. It is often described as a blowing, whooshing, or rasping noise. Heart murmurs can be innocent (harmless and not associated with any heart disease) or pathological (indicating an underlying heart condition). They are typically detected during routine physical examinations using a stethoscope. The classification of heart murmurs includes systolic, diastolic, continuous, and functional murmurs, based on the timing and auscultatory location. Various heart conditions, such as valvular disorders, congenital heart defects, or infections, can cause pathological heart murmurs. Further evaluation with diagnostic tests like echocardiography is often required to determine the underlying cause and appropriate treatment.
Heart auscultation is a medical procedure in which a healthcare professional uses a stethoscope to listen to the sounds produced by the heart. The process involves placing the stethoscope on various locations of the chest wall to hear different areas of the heart.
The sounds heard during auscultation are typically related to the opening and closing of the heart valves, as well as the turbulence created by blood flow through the heart chambers. These sounds can provide important clues about the structure and function of the heart, allowing healthcare professionals to diagnose various cardiovascular conditions such as heart murmurs, valvular disorders, and abnormal heart rhythms.
Heart auscultation is a key component of a physical examination and requires proper training and experience to interpret the findings accurately.
Phonocardiography is a non-invasive medical procedure that involves the graphical representation and analysis of sounds produced by the heart. It uses a device called a phonocardiograph to record these sounds, which are then displayed as waveforms on a screen. The procedure is often used in conjunction with other diagnostic techniques, such as electrocardiography (ECG), to help diagnose various heart conditions, including valvular heart disease and heart murmurs.
During the procedure, a specialized microphone called a phonendoscope is placed on the chest wall over the area of the heart. The microphone picks up the sounds generated by the heart's movements, such as the closing and opening of the heart valves, and transmits them to the phonocardiograph. The phonocardiograph then converts these sounds into a visual representation, which can be analyzed for any abnormalities or irregularities in the heart's function.
Phonocardiography is a valuable tool for healthcare professionals, as it can provide important insights into the health and functioning of the heart. By analyzing the waveforms produced during phonocardiography, doctors can identify any potential issues with the heart's valves or other structures, which may require further investigation or treatment. Overall, phonocardiography is an essential component of modern cardiac diagnostics, helping to ensure that patients receive accurate and timely diagnoses for their heart conditions.
A physical examination is a methodical and systematic process of evaluating a patient's overall health status. It involves inspecting, palpating, percussing, and auscultating different parts of the body to detect any abnormalities or medical conditions. The primary purpose of a physical examination is to gather information about the patient's health, identify potential health risks, diagnose medical conditions, and develop an appropriate plan for prevention, treatment, or further evaluation.
During a physical examination, a healthcare provider may assess various aspects of a patient's health, including their vital signs (such as blood pressure, heart rate, temperature, and respiratory rate), height, weight, body mass index (BMI), and overall appearance. They may also examine different organ systems, such as the cardiovascular, respiratory, gastrointestinal, neurological, musculoskeletal, and genitourinary systems, to identify any signs of disease or abnormalities.
Physical examinations are an essential part of preventive healthcare and are typically performed during routine check-ups, annual physicals, and when patients present with symptoms or concerns about their health. The specific components of a physical examination may vary depending on the patient's age, sex, medical history, and presenting symptoms.
In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.
Echocardiography is a medical procedure that uses sound waves to produce detailed images of the heart's structure, function, and motion. It is a non-invasive test that can help diagnose various heart conditions, such as valve problems, heart muscle damage, blood clots, and congenital heart defects.
During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest or passed through the esophagus to obtain images of the heart. The sound waves produced by the transducer bounce off the heart structures and return to the transducer, which then converts them into electrical signals that are processed to create images of the heart.
There are several types of echocardiograms, including:
* Transthoracic echocardiography (TTE): This is the most common type of echocardiogram and involves placing the transducer on the chest.
* Transesophageal echocardiography (TEE): This type of echocardiogram involves passing a specialized transducer through the esophagus to obtain images of the heart from a closer proximity.
* Stress echocardiography: This type of echocardiogram is performed during exercise or medication-induced stress to assess how the heart functions under stress.
* Doppler echocardiography: This type of echocardiogram uses sound waves to measure blood flow and velocity in the heart and blood vessels.
Echocardiography is a valuable tool for diagnosing and managing various heart conditions, as it provides detailed information about the structure and function of the heart. It is generally safe, non-invasive, and painless, making it a popular choice for doctors and patients alike.
Veterinary surgery refers to the surgical procedures performed on animals by trained veterinarians or veterinary surgeons. It involves the use of various surgical techniques and tools to diagnose, treat, or prevent diseases and injuries in animals. This can include soft tissue surgeries such as abdominal or thoracic surgeries, orthopedic surgeries for bone and joint issues, neurological surgeries, oncological surgeries for the removal of tumors, and reconstructive surgeries. Veterinary surgeons must complete extensive education and training in order to provide safe and effective surgical care for animals.
There is no medical definition for "dog diseases" as it is too broad a term. However, dogs can suffer from various health conditions and illnesses that are specific to their species or similar to those found in humans. Some common categories of dog diseases include:
1. Infectious Diseases: These are caused by viruses, bacteria, fungi, or parasites. Examples include distemper, parvovirus, kennel cough, Lyme disease, and heartworms.
2. Hereditary/Genetic Disorders: Some dogs may inherit certain genetic disorders from their parents. Examples include hip dysplasia, elbow dysplasia, progressive retinal atrophy (PRA), and degenerative myelopathy.
3. Age-Related Diseases: As dogs age, they become more susceptible to various health issues. Common age-related diseases in dogs include arthritis, dental disease, cancer, and cognitive dysfunction syndrome (CDS).
4. Nutritional Disorders: Malnutrition or improper feeding can lead to various health problems in dogs. Examples include obesity, malnutrition, and vitamin deficiencies.
5. Environmental Diseases: These are caused by exposure to environmental factors such as toxins, allergens, or extreme temperatures. Examples include heatstroke, frostbite, and toxicities from ingesting harmful substances.
6. Neurological Disorders: Dogs can suffer from various neurological conditions that affect their nervous system. Examples include epilepsy, intervertebral disc disease (IVDD), and vestibular disease.
7. Behavioral Disorders: Some dogs may develop behavioral issues due to various factors such as anxiety, fear, or aggression. Examples include separation anxiety, noise phobias, and resource guarding.
It's important to note that regular veterinary care, proper nutrition, exercise, and preventative measures can help reduce the risk of many dog diseases.
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Heart Murmurs