The following simple screening process has been developed to help you determine whether dogs suspected of having myxomatous mitral valve disease (MMVD) have evidence of disease progression.

Auscultate dogs
at risk of MMVD
Murmur MURMUR DETECTED
Adult
Dogs > 15 months and small breeds < 20 kg
Young
Dogs < 15 months
MMVD likely
Congenital disease likely
Left-sided murmur
≥
right-sided murmur
Dog Left-sided murmur
(left thorax)
Right-sided murmur
(right thorax)
Systolic SYSTOLIC
Continuous CONTINUOUS
Diastolic DIASTOLIC
Measure the point of maximal intensity (PMI)
PMI identifies the location where the murmur is heard loudest
PMI at left apex
PMI at left heart base
BAND SHAPE
Intensity stays the same
Changing intensity
Murmur grade < 3/6
Murmur grade ≥ 3/6
Calendar RE-EXAMINATION
in 6-12 months
CLINICALLY RELEVANT MURMUR
CONSISTENT WITH MMVD
Further examination to check for cardiomegaly
(e.g. VHS, VLAS and echocardiogram)
Consider referral to a cardiologist
Consider referral to a cardiologist
Consider referral to a cardiologist
Consider referral to a cardiologist

VHS = vertebral heart sum; VLAS = vertebral left atrial size.