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So Your Horse Has a Heart Murmur, Now What?

%QUINE 7ELLNESS

$R 7ENDY -OLLAT

9
OUR HORSE´S HEART WORKS JUST LIKE YOURS AND MINE IT HAS
FOUR CHAMBERS SEPARATED BY VALVES THAT OPEN AND CLOSE
TO ENSURE BLOOD FLOWS IN THE APPROPRIATE DIRECTION AS
THE HEART BEATS "EING THE HEART OF A HORSE IS NO SMALL JOB ¯ THE
AVERAGE HORSE HAS  GALLONS OF BLOOD THAT
HAS TO BE CONTINUOUSLY CIRCULATED TO SUPPLY
THE NECESSARY OXYGEN AND NUTRIENTS TO THE
BODY´S TISSUES )F YOU HAVE EVER LISTENED
&LOW MURMURS ARE REASONABLY COMMON IN THE HORSE AND ARE
GENERALLY ONLY A GRADE  OR GRADE  INTENSITY &OR THIS REASON IT
IS GENERALLY RECOMMENDED THAT HORSES WITH A MURMUR GRADE 
OR GREATER HAVE FURTHER DIAGNOSTICS TO DETERMINE IF THERE IS AN
UNDERLYING CARDIAC PROBLEM CAUSING THE
MURMUR )F YOUR VETERINARIAN DETERMINES
THAT YOUR HORSE HAS A MURMUR THEY MAY
ASK IF YOU HAVE NOTICED ANY EXERCISE INTOL
TO YOUR HORSE´S HEART YOU HAVE HEARD THE ERANCE SWELLING BETWEEN THE FRONT LEGS OR
RHYTHMIC ±LUB
DUB² SOUND WITH THE ±LUB²
BEING CAUSED BY THE CLOSING OF THE TRICUSPID
AND MITRAL VALVES AND THE ±DUB² BEING CAUSED
BY THE CLOSING OF THE AORTIC AND PULMONIC
VALVES /N AVERAGE THIS CYCLE OCCURS ON 
TIMES PER MINUTE WHILE AT REST ¯ FOR THEIR
ENTIRE LIFE
)N GENERAL MURMURS ARE CAUSED BY
TURBULENT BLOOD FLOW THAT PRODUCES A
VIBRATION THAT IS AUDIBLE GENERALLY WITH A
SHORTNESS OF BREATH
)F YOUR VETERINARIAN RECOMMENDS FURTHER
INVESTIGATION INTO YOUR HORSE´S HEART MURMUR
YOU WILL NEED TO SCHEDULE AN APPOINT
MENT WITH A CARDIOLOGIST HEART SPECIALIST 
'ENERALLY THIS CONSULT WILL INCLUDE AN ELEC
TROCARDIOGRAM %#' AND ECHOCARDIOGRAM
ULTRASOUND OF THE HEART  4HE %#' IS USED TO
DETERMINE IF THE HEART RATE AND RHYTHM ARE
NORMAL 4HE ULTRASOUND ALLOWS FOR IMAGING
STETHOSCOPE  -OST MURMURS OCCUR WHEN A OF THE HEART INCLUDING CHAMBER SIZE MUSCLE
VALVE BECOMES LEAKY ALLOWING BLOOD TO FLOW THICKNESS VALVE FUNCTION AND THE EFFECTIVE

BACKWARDS OR WHEN BLOOD IS BEING PUMPED NESS OF THE HEART´S CONTRACTION PHASE 7ITH
THROUGH A NARROWED OPENING STENOSIS  )N THESE PIECES INFORMATION THE SPECIALIST CAN
HORSES HEART MURMURS CAN OCCUR AT ANY AGE LOCALIZE THE ORIGIN OF THE MURMUR DETERMINE
AND MAY OR MAY NOT SIGNIFY THE PRESENCE OF IF THERE IS ANY SECONDARY HEART DAMAGE FROM
A STRUCTURAL PROBLEM WITHIN THE HEART 4HE TWO MOST COMMON THE MURMUR AND MAKE SOME PREDICTION ON ITS SIGNIFICANCE WITH
TYPES OF MURMURS IN HORSES ARE DUE TO INSUFFICIENCY OF THE AORTIC RESPECT TO FUTURE PERFORMANCE 9OU SHOULD EXPECT THAT THE EXAM
VALVE OR MITRAL VALVE &UNCTIONAL OR FLOW MURMURS ALSO OCCUR IN WILL TAKE ABOUT  HOURS AND IS GENERALLY PERFORMED AT AN EQUINE
HORSES THAT ARE DEHYDRATED OR AS THE RESULT OF RAPID BLOOD FLOW SPECIALTY PRACTICE NWHS
INTO A LARGE VESSEL OR THE HEART 7HILE THESE MURMURS ARE NO
CAUSED BY AN UNDERLYING CARDIAC PROBLEM IT IS DIFFICULT TO DISTIN

GUISH THEM FROM A PROBLEMATIC MURMUR WITHOUT ADDITIONAL About the Author
TESTING 7ENDY -OLLAT $6- $IPLOMATE !#6)-
7HEN YOUR VETERINARIAN IDENTIFIES A MURMUR THEY WILL $R -OLLAT RECEIVED HER VETERINARY DEGREE FROM
DESCRIBE IT BASED UPON WHEN IT OCCURS IN THE CARDIAC CYCLE HOW /REGON 3TATE  3HE COMPLETED HER INTERN

LOUD IT IS AND ITS LOCATION -URMURS THAT OCCUR DURING OR AFTER THE
±LUB² ARE REFERRED TO AS SYSTOLIC CONTRACTION OF THE HEART WHILE
THOSE ASSOCIATED WITH THE ±DUB² SOUND ARE DIASTOLIC RELAXATION
OF THE HEART  4HE INTENSITY OF THE MURMUR IS REFERRED TO AS THE
GRADE $EPENDING UPON THE SYSTEM USED THE SCALE GOES FROM
 QUIETEST TO  OR  LOUDEST  4HE POINT OF MAXIMAL INTENSITY
LOUDEST POINT OF THE MURMUR CAN OCCUR ON THE RIGHT OR THE
SHIP AT 0ILCHUCK 6ETERINARY (OSPITAL IN 
AND ½NISHED HER RESIDENCY AT 5NIVERSITY OF
#ALIFORNIA AT $AVIS  $R -OLLAT´S INTEREST
IN %QUINE )NTERNAL -EDICINE IS DRIVEN BY HER
DESIRE TO ½ND ANSWERS TO COMPLEX CASES THAT
LEAD TO AN APPROPRIATE TREATMENT PLAN OR
PROVIDE PEACE OF MIND FOR OWNERS AND REFERRING VETERINARIANS (ER
LEFT OF THE CHEST AND IS USED TO ROUGHLY LOCATE THE ORIGIN OF THE SPECIAL INTERESTS INCLUDE ') DISEASE BIOSECURITY NEUROLOGIC DISEASE
MURMUR AND NEONATOLOGY

May 2011 The Northwest Horse Source www.nwhorsesource.com