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Heart Murmur in Dogs

A heart murmur in dogs is an abnormal sound heard during a veterinary consultation when the vet listens to the heart with a stethoscope. This sound is caused by turbulence of the blood flow within the heart or into the major blood vessels connected to the heart.

It is important to note that a heart murmur is not a diagnosis, but a clinical finding. In other words, it tells the veterinarian that blood flow is not moving as expected, but it does not explain the cause.

Heart murmurs can be harmless or incidental findings, but they can also be a sign of heart disease. Many dogs with heart murmurs can live comfortably for many years, especially when the murmur is identified early and treated appropriately. Thus, with routine veterinary care and monitoring, a heart murmur does not always mean a poor quality of life for a dog.

Understanding Heart Murmurs in Dogs

In a healthy dog’s heart, blood flows in a smooth, coordinated way, producing regular and quiet “lub-dub” sounds. When blood flow becomes disrupted (due to changes in heart valves, heart chambers, blood characteristics, etc.), it creates a vibration that can be heard as a murmur.

Usually, veterinarians will describe a heart murmur based on their timing, location, and intensity. However, one of the most common features is the intensity, which is categorized into Grade I to Grade VI. Lower-grade murmurs are very soft and may only be detected under ideal conditions. Higher-grade murmurs are louder and easier to hear. However, it is important to note that grading helps guide clinical decisions, but it alone does not determine disease severity. Thus, even a lower-grade murmur may still be associated with underlying heart disease.

Signs and Symptoms of Heart Murmur in Dogs

Some dogs will not show any symptoms, particularly in the early stages. But, when signs are present, they may reflect how effectively the heart is compensating. For instance:

Early or mild signs:

  • Symptoms may not be noticeable
  • Some exercise tolerance
  • A murmur may be detected during a routine vet visit

Progressive Signs:

  • Fatigue
  • Coughing, more at night or after activity
  • Increased respiratory rate while resting

Advanced signs:

  • Labored and/or rapid breathing
  • Collapse and/or weakness
  • Fluid buildup that can cause abdominal distension (ascites) 
  • Lethargy

Common Causes and Risk Factors

Some of the common causes may include degenerative valve disease, such as mitral valve disease in small and senior dogs, congenital heart defects present from birth, and cardiomyopathies that affect the muscle of the heart and are more commonly seen in larger breeds than small breeds. In some cases, murmurs can be secondary to conditions that are not related to cardiac conditions. For example, anemia, fever, or systemic illness, etc.

How Heart Murmurs in Dogs Are Diagnosed

First, a veterinarian should start with physical examination and auscultation. If a murmur is detected, the vet may request additional diagnostics to try to understand the underlying cause and assess heart function, such as echocardiography (cardiac ultrasound), which is considered the gold standard for evaluating heart structure and function. Chest X-rays may be used to assess heart size and lung health, and electrocardiogram (ECG) can help identify rhythm abnormalities in the heart.