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Small Animal Final Year > Cardiac Radiography > Flashcards

Cardiac Radiography Flashcards

1
Q

What are the indiciation for thoracic radiography? (3)

A

–Identification, location and quantification of lesions producing respiratory signs (coughing) (typically dyspnoea/cough)

–Identification of lesions too small to produce clinical signs

•E.g. Looking for metastasis

–Assess effectiveness once we have started a treatment

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2
Q

What does radiography NOT identify?

A

CAUSE of heart disease

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3
Q

What type of heart failure is radiography good for? How do you know it is this?

A

Left heart failure

Evidence of cardiac enlargement?

Identify fluid in the lungs or pleural space

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4
Q

Why might it be hard to generate radiographs of diagnostic quality? (5)

A

–Movement blur (respiratory)

–Wide radiographic contrast

–Interpretation! (New grads- malcolm doesn’t agree..)

–Breed normals/age normals

–Inspiratory/expiratory

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5
Q

How can we minimise movement blur? (3)

A
  • Careful handling
  • Sedation/GA

–Dyspnoeic cat may just sit there

•Reduce exposure time

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6
Q

Wha positions may we do for radiography? What are they good to show?

A

•Lateral - right (left) - heart

–BOTH LATERALS – LUNG METASTASES

–Whetehr left or right laterally will depend on the x ray machine

  • Dorsoventral - heart
  • Ventrodorsal - lungs
  • Only time we put it on the back is a chronic cough and signs are stable! Never put a resp difficulty case on their back
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7
Q

Why do we no longer use the following positions?

  • Standing lateral
  • Standing erect
  • Recumbent VD with horizontal beam
A

Danger of the xray beam

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8
Q

What can obscure the thorax in lateral view?

A

Triceps

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9
Q

Where do we centre and collimate for lateral x ray?

A

Centre – cd scapula

Include small amount cr abdo

Thoracic inlet cr

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10
Q

What is the risk during interpretation if there is rotation?

A

Do not want to over-interpret

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11
Q

Where do we centre for a DV?

A

Caudal border of scapula

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12
Q

When would you do a VD view?

A

ONLY – chronic cough as you can get a good inspiratory bag by using breathing bag

As you want to see any evidence of airway making

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13
Q

What should we assess in the technical quality of a radiograph? (7)

A
  • Pink camels collect extra large apples on inspiration!
  • Positioning
  • Centring
  • Collimation
  • Exposure
  • Labelling
  • Artefacts
  • Inspiratory or expiratory? (hard to get fully inspiratory unless Ga and would need to interpret the film. No inspiratory – look more white (radiopaque)
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14
Q

What are some common artefacts to watch out for? (5)

A
  • Skin folds
  • Nipples
  • Cartilage mineralisation
  • Size and shape of cardiac silhouette
  • “Collapse” of dependent lung - do DV first!
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15
Q

Which X ray do we do first? Why?

A

Do DV first!

Lateral first means the one lung collapses slightly

This I the same dog – l (lateral first an lung collapsed) and right is lateral second.

If you take lateral first give a couple of breaths first

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16
Q

What does it mean to Assess “not the heart and lungs”.?

A

Peripheral soft tissue structures.

Anterior abdominal contents.

Thoracic skeleton.

Cranial mediastinum.

Caudal mediastinum.

Diaphragm.

Pleural space.

Then lungs – cardiac silhouette and then vessels

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17
Q

What is the normal cardiac silhouette? Both for lateral and DV?

A

Rules of thumb for lateral (3.5 rib spaces max)

Rules of thumb for DV (2/3 of width of thorax at rib 6 max)

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18
Q

How can you assess heart size?

A

Draw a line from trachea bifurcation to heart apex

Normally – 4 chambers should be distributed

DV – draw the line apex to base

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19
Q

If you have a 8 yo grade 4 systolic murmur no other signs CKCS

What do you look for?

A

Let side enlaargment

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20
Q

What is the normal height of the heart in lateral?

A

5th rib - 2/3 heart of thorax

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21
Q

What is the difference in deep vs narrow chest breeds with the heart silohouette?

A

Deep chest Narrow more upright chest

Narrow chest – chunkier, rounded cardiac silhouette

22
Q

On a DV image - where is the aniaml LHS on the image?

A

RHS

23
Q

If you have a Bulge 1-2 Enlarged RHS. Loud systolic murmur at heart base. What would you suspect?

A

Pulmonary stenosis?

24
Q

Looking at a DV heart what is at the ollowing times on a clock face:

  1. 12-1?
  2. 1-2?
  3. 2-4?
  4. 3-5?
  5. 5-9?
  6. 8-11?
A
  1. Aorta
  2. PA
  3. LA
  4. LV
  5. RV
  6. RA
25
Q

What is the vertebral heart scoring system and how does it work?

A

Length (L) is measured on lateral vs no number of vb bodies.

(starting at the cranial edge of T4).

Width (W) measured similarly.

VERTEBRAL HEART SCORE (VHS) = L + W

Average in dogs is 9.7 (range 8.5 - 10.5), 8 in cats.

26
Q

What should we find out from the cardiac silhouette? (3)

A

GENERALISED ENLARGEMENT.

INDIVIDUAL CHAMBER ENLARGEMENT.

  • LEFT ATRIUM.
  • RIGHT ATRIUM.
  • LEFT VENTRICLE.
  • RIGHT VENTRICLE.

CHANGES IN GREAT VESSELS.

27
Q

How do you know if there is a problem with the heart of a PC with fluid?

A

Auscultate

28
Q

What would this animal present with?

A

Heart this big must have evidence of heart disease - murmur, gallop etc.

29
Q

What is seen with a pericardial effusion? What can we do to confirm?

A
  • Whole cardiac silhouette grossly enlarged
  • Globular appearance
  • Outline distinct as no movement
  • Secondary signs of right-sided failure
  • Ultrasound very sensitive indicator –stick a probe on
30
Q

What can be seen?

A

Generalised enlargement – cardiac

LA enlargement on lateral and splitting on mainstem bronchi

Should hear on auscultation

31
Q

What is the problem with getting good at treating heart disease?

A

Heart can get super big - space occupying lesion

32
Q

This is a small breed dog which has had treatment - what are the problems?

A

Huge cardiac silo. Trachea being pushed.

33
Q

What is the issue here and what may hhave caused this?

A

Microcardia
Hypovolaemic animal
Small CS – here 2 rib spaces

34
Q

What is seen with left heart enlargement?

A

LA – back and middle

Straightening of caudal border

Tenting of LA

35
Q

What is shown here?

A

L

Heart Enlargement – Lat

Lost cd waist

LA is tenting

CS – tall

Arrow head (left) – large PV not surprised as large LA ad high pressure and the pressure in veins is high

Pulmonary venous HT

Hasn’t got any lung pattern – dog on the verge of pulmonary oedema (or been treated for) due to high venous pressure

V bigger than A above bronchus

36
Q

What is seen on this image?

A

Left Heart Failure – Lat

Should know from CS coughing etc – pulmonary oedema

Alveolar pattern (typical of LHF in diaphragmatic lobes (not normally in cr lobe))

Generalised increased density

Air bronchograms

37
Q

What is the issue here?

A

L Heart Enlargement – DV

See LA sitting on the back

38
Q

Where is the right side of the heart on lateral and what happens if tehre s enlargement?

A

Right Heart Enlargement – Lat

Right wraps around left. Increase in sternal contact and crcd dimension of the hear

39
Q

What is this?

A

Right Heart Enlargement - Lat

40
Q

How can you tell on DV if there is R side enlargement?

A

Development of a reverse D

41
Q

Where are the veins and arteries on DV? Where is easiest to see?

A

Veins – central

Arteries – lateral

Easier to see over diaphragm

42
Q

What is seen here?

A

Right Heart Enlargement – DV

43
Q

What is the normal feline heart shape and width on lateral?

A

–Width of heart is two IC spaces

–Looks like a lemon

44
Q

What is the normal DV feline heart width?

A

–Width is 0.66 width of thorax at 5th rib

45
Q

What happens in cat myocardial disease and what is the effect on the heart shape?

A

diastolic and heart cant fill = atria gets big. Wont be oval

Ventricle often normal

46
Q

What does this show?

A

valentine heart and atria got big and ventricle normal

RCM/HCM – big atria

47
Q

What is the normal cat size for:

Width DV?

Lateral short axis?

Lateral long axis?

A
48
Q

What changes in thoracic radiographs of older cats (3)

A

More horizontal heart

Prominent aortic arch (lays down on sternum a bit more )

Often have “spare” trachea and looks wavy

49
Q

What is the problem here?

A

Heart enlargement
By the time we see cats with HF – profound changes
Wide CS and pushing trachea up
Huge atria

50
Q

What is radiography not useful for in myocardial dx?

A

Distinguishing the forms of disease?

Small Animal Final Year (317 decks)

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