A harsh, grade 4/6 ejection type murmur (loudest over the left sternal border) is auscultated in this heart sound.
Purring makes appreciating the murmur difficult; careful auscultation between gaps in the purring is therefore important. Running water or holding a small cotton ball near the cat’s nose can stop the purring. Feline murmurs can be a result of dynamic left ventricular outflow tract obstruction (DLVOTO) from systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy; they could also be benign, physiologic murmurs of dynamic right ventricular outflow tract obstruction (DRVOTO; common in cats at high heart rates, but not clinically significant). Murmurs caused by dynamic ventricular outflow obstructions become louder as strength of contractions and heart rates increase. An echocardiogram is necessary to determine whether a benign DRVOTO or a pathologic DLVOTO is present.