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When should you consider referral of a patient?

Heart murmurs

  • Previously diagnosed “functional” murmur that is louder on serial examination

  • Grade 3-6/6 left-sided murmur consistent with MR or AR

  • Grade 4-6/6 right-sided systolic murmur consistent with TR

  • VSD or other congenital defect suspected

  • Continuous or combined systolic & diastolic murmur

  • Murmur during prepurchase examination

  • Pathologic cardiac arrhythmias (+/- murmur)

  • Suspected myocardial injury/damage

  • Suspicion of congestive heart failure (CHF)


  • Irregular arrhythmias at rest

  • Arrhythmias during or in the immediate period after excerise

  • Regular arrythmias that persist with exercise

  • History of collapse

, large VSDs)

Poor performance

  • No indication for muskuloskeletal or respiratory causes of poor performance

  • Poor performance associated with heart murmurs or arrhythmias

What to expect if you refer a patient?

We will first perform a comprehensive examination of the patient at the home stables or at the hospital. We will then analyze the echocardiogram and ECG offline and perform relevant measurements. A full report including all relevant data and recommendation will be send to you and the client.

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