Peer-reviewed veterinary case report
How blood test and stethoscope help spot heart problems in puppies
By Marinus, S M et al.·Published in Journal of veterinary internal medicine·2017·Department of Clinical Sciences of Companion Animals, Netherlands·View original on PubMed →
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Original publication title: N-Terminal Pro-B-Type Natriuretic Peptide and Phonocardiography in Differentiating Innocent Cardiac Murmurs from Congenital Cardiac Anomalies in Asymptomatic Puppies.
- Species:
- dog
Plain-English summary
A group of 186 asymptomatic puppies, including many Cairn Terriers, were evaluated for heart murmurs to determine if they were harmless or caused by serious heart defects. Researchers found that while certain blood tests (NT-proBNP levels) could indicate heart disease, they weren't always reliable, as some puppies with severe heart issues had normal levels. They also discovered that the duration and strength of the murmur sound could help differentiate between innocent and abnormal murmurs. Murmurs lasting longer than 80% of the heartbeat were likely abnormal, while shorter murmurs could be either harmless or serious.
People also search for: puppy heart murmur treatment · Cairn Terrier heart problems · how to tell if a puppy has a heart defect
Abstract
BACKGROUND: Differentiating innocent cardiac murmurs from murmurs caused by congenital cardiac anomalies can be challenging with auscultation alone in asymptomatic puppies. HYPOTHESIS: Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and phonocardiograms recorded by an electronic stethoscope can differentiate innocent from pathologic cardiac murmurs. ANIMALS: A total of 186 client-owned asymptomatic dogs: 135 Cairn Terriers (age: 45-124 days), 20 adult Cairn Terriers (age: 7.5 months to 13.5 years), and 31 puppies of various breeds (age: 29-396 days). METHODS: Study design is a cross-sectional survey. Each dog was auscultated, and when a cardiac murmur was heard, a phonocardiogram was recorded and an echocardiogram was performed. Plasma NT-proBNP concentrations were measured by a single laboratory by an ELISA. RESULTS: No significant (P = .41) difference in plasma NT-proBNP levels was found between puppies without a murmur and puppies with an innocent murmur (median 300 versus 326 pmol/L), and between clinically healthy adult Cairn Terriers and Cairn Terrier puppies. Plasma NT-proBNP levels in puppies with a congenital heart disease were significantly (P < .001) higher than those in puppies with innocent murmurs (median 1,102 versus 326 pmol/L). However, some puppies with severe pulmonic stenosis did not have increased plasma NT-proBNP levels. On phonocardiograms, innocent murmurs had a significantly (P < .001) shorter "murmur-to-systole duration ratio" than the abnormal ones (median 66 versus 100%). The "murmur-to-S1 (first cardiac sound) amplitude ratio" was significantly (P < .001) lower of the innocent murmurs compared with that of the abnormal ones (median 16 versus 58 %). CONCLUSIONS AND CLINICAL IMPORTANCE: Plasma NT-proBNP concentrations within the reference range do not rule out a congenital cardiac anomaly. Murmurs longer than 80% of the systole are most likely abnormal, whereas murmurs shorter than that could be either innocent or pathologic.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/28316101/