Cardiology NAVLE Guide
Dog and Cat Murmur Approach: Triage and Workup Logic
A murmur is a finding, not a diagnosis. This guide helps you classify urgency, connect murmur characteristics with likely disease categories, and choose the next best diagnostic step.
Use this guide to move from first-pass pattern recognition to structured diagnostic and treatment logic. The flow is designed for NAVLE-style decision sequencing and practical ward preparation.
Rapid Algorithm
- Assess whether murmur occurs with signs of instability or incidental routine exam finding.
- Characterize intensity, timing, point of maximal intensity, and concurrent rhythm pattern.
- Match signalment and murmur profile to most likely structural or functional causes.
- Select imaging and pressure evaluation priorities based on risk profile.
- Set monitoring interval and escalation criteria when immediate intervention is not required.
Diagnostic Flow
- Thoracic imaging and echocardiography context define structural significance.
- Blood pressure and perfusion evaluation may reveal hemodynamic impact not obvious on auscultation.
- ECG support is useful when arrhythmia signs accompany auscultation findings.
- Laboratory baseline helps assess comorbidity before treatment decisions.
- Serial examinations prevent missed progression in initially stable patients.
Treatment Flow
- Treat based on confirmed disease process and clinical impact, not murmur grade alone.
- Escalate rapidly when murmur accompanies respiratory distress, syncope, or poor perfusion.
- Plan follow-up cadence around progression risk and owner observation capability.
- Integrate stage-specific medication logic after diagnostic confirmation.
- Document objective response markers for each follow-up cycle.
Exam Traps
- Overweighting murmur loudness without location and timing context can mislead diagnosis.
- Assuming all feline murmurs imply severe structural disease causes over-correction.
- Skipping blood pressure and rhythm assessment may miss major contributors.
- Failing to plan recheck intervals can miss progression in asymptomatic patients.
- Ignoring syncopal history in murmur cases underestimates risk.
Practice Prompts
- What murmur features most influence immediate workup urgency?
- How does signalment change top differentials for systolic murmurs?
- When should echocardiography be prioritized over delayed follow-up?
- Which findings convert a murmur case from elective to urgent?
- How can owners monitor progression safely at home?
Related Content
Sources and Review Notes
- Drug label search (DailyMed)
- IRIS stages
- Normal lab values
- Heartworm treatment protocol
- Lab test protocols
- Microchip lookup
- Vertebral Heart Score
- BCS charts
- ACVIM cardiology consensus guideline references
- Dental charts
- AAHA vaccination guidelines
- Flea/tick product info
- Dog/cat breed search
- RECOVER CPR guidelines
Last reviewed: February 13, 2026
Educational only. This page is designed for study and does not replace case-specific diagnosis, local protocols, or direct supervision.