title: An assessment of the terminology used by diplomates and students to describe the character of equine mitral and aortic valve regurgitant murmurs: correlations with the physical properties of the sounds.
abstract: Twenty students and 16 diplomates listened to 7 recordings made from 7 horses with either aortic (n = 3) or mitral valve (n = 4) regurgitant murmurs. A total of 30 different terms were used to describe the character of these murmurs. However, only 4 terms were used in a repeatable and consistent manner. Most people described the character of a given mitral or aortic valve murmur with 1 or 2 terms. Diplomates drew from a pool of terms that was about half the size of that used by students--8.1 +/- 2.0 terms for diplomats (mean +/- 1 SD) versus 13.1 +/- 1.8 terms for students (P > .001). Only blowing, honking, buzzing, and musical were markedly associated with the recording played. Frequency analysis of the murmurs allowed them to be classified as containing harmonics (n = 4) or not containing harmonics (n = 3). Blowing was used to describe murmurs without harmonics on 39 of 48 occasions and corresponds to the term noisy used in some older descriptions of equine murmurs. Honking, musical, and buzzing were markedly associated with murmurs that contained harmonics; these terms were used 23, 13, and 12 of a possible 64 times, respectively. The frequency of buzzing and honking murmurs (72.7 +/- 9.3 and 88.4 +/- 46.3 Hz, respectively) was markedly lower than that of musical murmurs (156.8 +/- 81.1 Hz) (all P values < .01). Honking murmurs (0.392 +/- 0.092 seconds) were shorter than those described as buzzing or musical (0.496 +/- 0.205 and 0.504 +/- 0.116 seconds, respectively). The data suggest that the terminology for the character of aortic and mitral regurgitant murmurs should be restricted to 4 terms: blowing, honking, buzzing, and musical. Honking, buzzing, and musical describe murmurs with a peak dominant frequency and harmonics; blowing describes murmurs without a peak frequency. Effective communication could be enhanced by playing examples of reference sounds when these terms are taught so that nomenclature is used more uniformly.
authors.affiliation: Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. jon.naylor@usask.ca
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Naylor
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Wolker
authors.forename: John W
authors.initials: JW
authors.lastname: Pharr
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000503:physiopathology*; D004520:Education, Veterinary; D006326:Heart Auscultation / Q000662:veterinary*; D006337:Heart Murmurs / Q000145:classification / Q000175:diagnosis* / Q000662:veterinary*; D006347:Heart Sounds / Q000502:physiology; D006734:Horse Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D006736:Horses; D008943:Mitral Valve / Q000503:physiopathology*; D013334:Students; D009626:Terminology as Topic; D018634:Veterinarians