grade 2 heart murmur

[freak71]

Looking to adopt a Golden retriever pup. HOWEVER he has a grade 2 heatr murmur any help would be great. Gift for my downsyndrom son who is ten.

[mona_b]

How old is the pup?

That grade of heart murmur is not all that bad..A pup will usually outgrow it by 12-18 weeks of age. One of my neices pups had it..And at 5 months Nikkita is doing great and murmur free....

But, (yes there is a but) that is not always the case...At times the heart murmur will worsen..I think the stages are 1-10.

I'm hoping Dr.Lee will see this. He will be able to explain it better.

[freak71]

he is 11weeks old thanks

[Dr Lee]

There are 6 grades that refer to heart murmur sound intensity. These grades do NOT always correlate to the severity of cardiac disease. This means that a life threatening cardiac disease can be described as a grade I or II murmur (or even have no murmur at all!) and benign murmurs can sometimes have high grade sound intensities. With this said, if a murmur increases in severity, then we are concerned that the cardiac disease has progressed.

This is from John D. Bonagura, DVM, MS, Diplomate ACVIM (Cardiology, Internal Medicine) of The Ohio State University in a lecture entitled: Cardiac Auscultation

"The description of cardiac murmurs should include timing, intensity, point of maximal intensity (PMI), radiation, pitch and quality. The timing of the murmur is systolic, diastolic, continuous, or to-and-fro (systolic-diastolic). The intensity of the murmur is arbitrarily graded on a 1-6 scale; we use the following convention:

Grade 1 = a very soft, localized murmur detected only in a quiet room after minutes of intense listening.
Grade 2 = a soft murmur, heard immediately, localized to a single valve area.
Grade 3 = a moderate intensity murmur that is evident at more than one location.
Grade 4 = a moderate intensity to loud murmur; radiates well; but a consistent precordial thrill is not present.
Grade 5 = a loud murmur accompanied by a palpable precordial thrill.
Grade 6 = a loud murmur with a precordial thrill, audible when the stethoscope is removed from the thorax."

With reference to young murmurs, this is from William D. Fortney, DVM of Kansas State University from a lecture entitled, "Neonatal Clinical Findings: Is it Normal or a Problem (VET-311)"

"Functional / innocent / physiologic murmurs are soft (grade > III/VI) early systolic, are heard best at the left base, change with position, and do not persist past 12 weeks. These murmurs are usually idiopathic but can be associated with increased blood velocity associated with stress, fever, sepsis, anemia or hypoproteinemia."

Mona, I do agree that with a grade II/VI murmur in a young puppy, we just don't know but that many puppies can have 'innocent murmurs' which are self-limiting. How do we tell? Option 1) wait and repeat examination in 2-4 weeks. or option 2) cardiac ultrasound.

If the murmur persists or worsens, then cardiac ultrasound is definitely indicated.

Hope this helps clarify.