grade V murmur in a kitten with a VSD
Loud murmurs with thrills in young animals don’t, on the face of it, sound good. Certainly in aortic stenosis, pulmonic stenosis and PDAs louder murmurs are usually associated with more severe disease.
This kitten is about 10 weeks old and has the most dramatic murmur with an obvious thrill palpable over much of the right hemithorax.
However, the cause is a relatively small ventricular septal defect:
Right-sided transverse plane view of the heart at a level just below the aortic valve.
Flow through the defect is relatively fast -indicating that a relatively normal LV > RV pressure gradient is present. And that velocity is maintained through systole -since insufficient blood is crossing to cause equilibration.
the same view with PW Doppler interrogation of flow through the VSD
This type of loud murmur associated with small VSDs is called a ‘Roger’s murmur’ -I didn’t make that up. Google it.
Rule 1 of congenital cardiac defects is ‘when you find a defect, look really hard for evidence of concurrent problems elsewhere in the heart’. Multiple defects in the same patient are common.
So, no evidence of L > R PDA here.
Right transverse view at the level of the pulmonary artery with CW Doppler
And the rest of the echocardiogram was unremarkable with no evidence of any chamber enlargement. Her prognosis is probably good despite the murmur.
