The
possibility to study a graphic recording (PCG) of auscultatory findings
is often a helpful diagnostic tool for the clinician. Phonocardiography
is a graphic recording of heart sounds and murmurs picked up by
a microphone or sensor that is placed on the chest wall of the animal.
The recorded sound may be filtered and printed on paper or displayed
on the screen of a computer. Each filter amplifies sounds around
a certain frequency (so called nominal frequencies) and dampens
other sounds.
The use of filters with different nominal frequencies of 50, 100,
200, 400 Hz and an aural filter (50-500 Hz) is useful to determine
if a murmur has low, medium or high frequency components, and to
remove disturbing background noise and respiratory sounds. To record
ECG simultaneously with PCG is essential for timing the sounds and
murmurs to the electrical activity of the heart. This timing may
not be needed if S1 can be correctly
identified. However, this is not always the case, especially not
in cases with tachycardia or gallop rhythms. PCG has previously
been recorded on multichannel ECG machines equipped with a PCG amplifier,
but recording with a sensor based stethoscope*
connected to a computer is now possible and for several reasons
more practical for the future.
A practical advantage with PCG is that it is instructive to have
a graphic display of the heart sounds and murmurs at hand during
discussion and explanation of diagnosis, and sometimes prognosis,
with students and clients. For the practitioner PCG offers the opportunity
to file heart sounds that may be useful for legal or insurance purposes.
Evaluation of the timing, shape and frequency components of the
heartbeat can be done objectively from the recording. For example,
ejection murmurs may especially, at high heart rates, be very difficult
to distinguish from holosystolic murmurs by auscultation but can
easily be distinguished by phonocardiography. Time intervals on
the PCG can also be measured, filed and compared with recordings
from other animals or from consecutive examinations.
A new interesting option, available with the
Meditron PCG analysing
system, is a possibility to perform two or three-dimensional
spectral analyses
of recorded murmurs. Future research will presumably develop this
form of heart sound analysis, further improving the diagnostic possibilities
of phonocardiography. |
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