My dog has a heart murmur…now what. A heart murmur is caused by turbulent blood flow in the heart. In the exam room your doctor will grade a heart murmur, from one to six, based on how loud it is. The grades of a murmur often, but does not always, correspond to the severity of heart disease. Staging is a far more accurate way of assessing the degree of heart disease and guides our therapeutic interventions. Only 30% of dogs with an audible murmur ever go into heart failure. Staging heart disease There are four stages of heart disease: Stage A- there is no audible murmur but the animal is genetically predisposed Stage B- there is an audible heart murmur but there are no clinical signs Stage B1- no heart enlargement measured on chest radiograph (x-ray) yet Stage B2- radiographs indicate heart enlargement Stage C- Congestive heart failure: heart enlargement and pulmonary edema are present on x-ray Stage D- Refractory congestive heart failure: Patient is not responding to treatment and intensive support is required for life. This is end stage heart failure. Diagnostically moving through the stages If your dog is a breed predisposed to a heart murmur (Stage A) we continue to monitor for a heart murmur at annual exam appointments. Once we hear a heart murmur, we know to stage your pet accordingly. Stage B. When a heart murmur is first detected we recommend baseline radiographs, blood pressure measurement, bloodwork, and urinalysis. This is the point in time when your pet is the healthiest it will ever be with heart disease so it is important to establish what is normal for your pet. The chest radiographs allow us to measure the size of the heart to determine if there is heart enlargement. If the radiographs show normal heart size (stage B1) then cardiologists recommend repeat radiograph every 6 months to monitor for enlargement. We measure blood pressure to ensure your pet is not hypertensive as high blood pressure can worsen or speed up the progression of heart disease. Blood work and urinalysis help us assess your pet’s organ function and overall health as some of the medications we may be prescribing in the future can affect these. Depending on your pets breed and age a heart ultrasound or echocardiogram may also be recommended at this time.
My dog has a heart murmur…now what. A heart murmur is caused by turbulent blood flow in the heart. In the exam room your doctor will grade a heart murmur, from one to six, based on how loud it is. The grades of a murmur often, but does not always, correspond to the severity of heart disease. Staging is a far more accurate way of assessing the degree of heart disease and guides our therapeutic interventions. Only 30% of dogs with an audible murmur ever go into heart failure. Staging heart disease There are four stages of heart disease: Stage A- there is no audible murmur but the animal is genetically predisposed Stage B- there is an audible heart murmur but there are no clinical signs Stage B1- no heart enlargement measured on chest radiograph (x-ray) yet Stage B2- radiographs indicate heart enlargement Stage C- Congestive heart failure: heart enlargement and pulmonary edema are present on x-ray Stage D- Refractory congestive heart failure: Patient is not responding to treatment and intensive support is required for life. This is end stage heart failure. Diagnostically moving through the stages If your dog is a breed predisposed to a heart murmur (Stage A) we continue to monitor for a heart murmur at annual exam appointments. Once we hear a heart murmur, we know to stage your pet accordingly. Stage B. When a heart murmur is first detected we recommend baseline radiographs, blood pressure measurement, bloodwork, and urinalysis. This is the point in time when your pet is the healthiest it will ever be with heart disease so it is important to establish what is normal for your pet. The chest radiographs allow us to measure the size of the heart to determine if there is heart enlargement. If the radiographs show normal heart size (stage B1) then cardiologists recommend repeat radiograph every 6 months to monitor for enlargement. We measure blood pressure to ensure your pet is not hypertensive as high blood pressure can worsen or speed up the progression of heart disease. Blood work and urinalysis help us assess your pet’s organ function and overall health as some of the medications we may be prescribing in the future can affect these. Depending on your pets breed and age a heart ultrasound or echocardiogram may also be recommended at this time.
staging_heart_disease.docx