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Heart Murmurs and Valvular Heart Disease in the Horse

By: Dr. Melissa Mazan

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Aortic regurgitation

Buttercup was a 22 year old mare, who had been in the company of the same owner for the past 12 years. Buttercup had never had any major illnesses; nevertheless, she had a "well horse" examination performed by her veterinarian every year.

This year, Dr. Green heard a murmur between in the interval between the second and first heart sounds, which means that it was diastolic, and it had the sound of a cooing dove. He suspected that Buttercup had aortic regurgitation. Although he didn't find any signs of cardiac failure on examination, he ordered an echo done just to be careful.

Dr. Green asked the following questions of the owner:
  • Does Buttercup seem to tire more easily?

  • Does she ever cough?
  • Has she had any fevers?
  • Have you had to increase her feed to keep weight on her?

    The answer to all these questions was 'no'. Buttercup was in excellent condition.

    When the cardiologist examined Buttercup the following week, she noticed the left side of the heart was slightly enlarged and noticed there was blood flowing backward through the aortic valve. This was responsible for the murmur, and for the mildly enlarged left heart.

    The cardiologist reassured Buttercup's owner that the horse did not show signs of cardiac failure, although she definitely had cardiac disease. Aortic regurgitation is the most common valvular problem in older horses. Although it is a degenerative disease, it tends to progress slowly.

    Buttercup did not need drugs for her heart, but sometime in the future she would probably need to be on drugs, such as digoxin to help strengthen her heart. He advised the owner to be a little more careful with Buttercup, but he advised the following:

  • Continue riding her but give her only light work.
  • Recheck her heart every six months to a year.
  • Be on the alert for signs of impending heart failure.
  • Get your own stethoscope and learn to monitor the quality of the murmur as well as Buttercup's resting heart rate.
  • Look to see if Buttercup's jugular veins become distended, or if she develops any edema under her abdomen.
  • Call Dr. Green immediately if the murmur seems to be louder, or if Buttercup's resting heart rate is steadily higher.         



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