CV Exam, Radiography, Echo Flashcards
What heart disease do you think of with old dogs
mitral valve degeneration
What heart disease do you think about with middle aged cats?
what about older cats?
Middle aged: hypertrophic cardiomyopathies
Old cats: systemic disease and secondary CV effects (hyperthroud)
What heart disease do you think of with younger horses
heart rhythm disturbances
-atrial fibrillation
what heart disease do you think of with older horses
aortic valve degeneration
what heart disease do you think of in cattle
right atrial lymphoma
endocarditis
pericardial disease
high altitude
Is PDA more common in male or female dogs
Females (3x more likely)
Is hypertrophic cardiomyopathy more common in male or female cats
males
Clinical signs of CV disease
-lethargy, exercise intolerance, reduced activity
-separation, hiding behavior
-syncope or exertional weakness
-respiratory signs (cough, rapid breathing)
-abdominal distension or subcutanous edema
-muscle/weight loss with chronic cardiac disease
-acute paresis (limb lameness)
-regurgitation
a brief loss of consciousness and postural tone due to reduced cerebral blood flow
may be caused by 1) abnormal heart rhythms, 2) excess vasodilation;
3) plasma volume contraction
syncope
what sign of heart disease might be confused with seizures
syncope
a brief loss of consciousness and postural tone due to reduced cerebral blood flow
What is unique about cats and horses during syncope events
looks like a focal seizure
-facial twitching is common
why do cats with heart disease typically cough
dogs do often cought as their is fluid accumulation in the lungs or pleural space
HOWEVER
cats seldom cough- respiratory signs are more often related to rapid (tachypnea) or labored (dyspnea) breathing
Dogs often cough as a respiratory sign of heart disease but cats do not. What will you see instead?
more often tachypnea (rapid breathing) or labored (dyspnea)
abnormality in respiration where the animal is breathing fast, typically more shallow
tachypnea
abnormality in respiration where the animal is breathing deeper
hyperpnea
abnormality in respiration where the animal is breathing in distress
dyspnea
exertional respiratory signs (abnormal respirations after periods of activity) of heart disease is seen in animals with
limited cardiopulmonary capacity
1) pulmonary hypertension
2) cyanotic heart disease
3) severe systolic dysfunction
4) congestive heart failure
what is one of the best things that you can have your client do to predict heart failure in an animal
client measured respiratory rate
do for patients at risk of heart disease
what is the difference between a cough vs reverse sneeze
cough: forced exhalation (lower airway)
reverse sneeze: forced inhalation (pharynx/upper airway)
what is a common sign of right sided CHF in dogs
cavitary effusion, often seen as ascites
what is a common sign in large animals with CHF, whether left sided or right sided
cavitary effusion (abdominal distension)
-Brisket edema
Cavitary effusion, often seen as ascites is a common sign of
right sided CHF
if animal has an AV fistula connection the femoral artery to the femoral vein. what might occur
swelling of the extremities (pelvic limb)
How might you get swelling of the extremities
1) high filling pressure
2) vascular obstruction
3) vascular communication (AV shunt)
limb paresis/claudication might be a potential sign of
arterial obstruction
need to rule out musculoskeletal and neurologic causes
cardiac cachexia
due to chronic heart failure resulting in catabolic state
protein is loss in cavitary effusions
edematous GI tract with poor absorption
impaired perfusion of vital organs
*end result is severe muscle and condition loss
How can we get cachexia with chronic heart failure
ailure resulting in catabolic state
protein is loss in cavitary effusions
edematous GI tract with poor absorption
impaired perfusion of vital organs
*end result is severe muscle and condition loss
why might you see regurgitation with esophageal dysfunction
vascular ring anomalies (persistent right aortic arch around the esophagus)
what does it mean if the mucous membranes are pale/white
anemia
poor cardiac output
severe vasoconstriction
What is the diaphragm of the stethoscope use for
high frequency sounds (nx heart and lung)
firm pressure with one-sided
what is the bell of the stethoscope used for
low frequency sounds such as gallops
light pressure with one sided
heaptojugular reflex
used for better evaluation of the jugular vein
what do pink mucous membranes mean
normal
what do red mucous membranes mean
vasodilation, erythrocytosis, stress
what do blue/purple mucous membranes mean
cyanosis (hypoxemia)
desaturated hemoglobin
a normal pulse is
palpable with light touch
a weak pulse is
hard to feel, occluded with light pressure
a strong pulse is
easy palpable, hard to occlude with firm pressure; felt in small peripheral arteries
what might be occuring if you notice a weak pulse
1) hypovolemia
2) poor cardiac output
3) LV outflow obstruction (subaortic stenosis)
what might be occurring if you notice a strong/bounding pulse
1) abnormal diastolic runoff of blood (AV shunt, PDA, aortic regurgitation
2) bradycardia- causing lowe diastole
3) Vasodilation- reduced vascular resistance (fever, anemia, exercise, thyroid, drugs)
4) High sympathetic tone
5) age and stiffening of arteries
when might pulse deficits occur
when there is an abnormal heart rhythm causing the heart to contract prematurely and close the AV valves but the stroke volume of the early beat may be inadequate to open the aortic valve or to lead to a palpable pulse in the peripheral artery
what might distension of the jugular veins tell you
increased plasma volume
or
impaired venous return back to heart (Right side disease, pericardial dz, cranial vena cava thrombis)
What might pulsation of the jugular veins tell you
there are refleted waves
1) tricuspid regurgitation
2) stiff/noncompliant right ventricle
what can retinal vessels and hemorrhage tell you
high blood pressure
What valves can you hear on the left side
start with mitral valve then go dorsal and a little cranial to hear the aortic valve then continue for the pulmonic
(PAM- cranial to caudal)
what can you hear on the right side
tricuspid valve
and ascending aorta
In cats when doing cardiac exams, localizing cardiac valves is much more difficult due to the size. What do you do instead
Locations are described as parasternal
*Left
*right and cranial
*caudal
not necessarily discrete valve locations
what can you do to get rid of purring when trying to evaluate the heart of a cat
use running water, alcohol in front of the nose, gentle pressure on larynx
artifacts that obscure auscultation
1) respiration and panting- may be louder than heart can sound like a murmur
2) purring: onscures ausculatation
3) excessive pressure- compliant thorac (kitten, puppy, chinchilla) your stethoscope pressure maycompress vessels and cause a murmur
4) moving the chest piece over the fur
5) muscle twitches
abrupt changes in pressure and flow; short duration (heart sounds)
transient sounds
T/F: in large animals both the 3rd and 4th heart sounds can be normal (diastolic soundsO
True
atrial contraction pushing blood into ventricle
phonocardiogram
allows you to see heart sounds graphically
not commonly employed
What causes the S1 sound
closure of mitral valve and tricuspid valve
what causes the S2 sound
closure of the aortic valve and pulmonic valve
what causes the S3 sound
early diastolic filling
what causes the S4 sound
late diastolic filling
where does S1 have the greatest intensity
at the apex
where does S2 have the greatest intensity
at the heart base
why might the heart sound intensity be softer
-obesity
-fluid accumulation (pleural or pericardial)
-myocardial failure (reduced contractility)
-mass lesion (diaphragmatic hernia)
when might the heart sound intensity be louder than expected
-increased sympathetic tone
-hypertension (systemic or pulmonary)
normal dog heart rate (in hospital)
70-150
normal cat heart rate (in hospital)
140-220
normal cow heart rate (in hospital)
45-70
normal horse heart rate (in hospital)
30-50
a regularly irregular heat rhythm
sinus arrhythmia
an irregularly irregular heart rhythm
atrial fibrillation
(no consistency)
diastolic sounds associated with ventricular filling
gallops
a mid-systolic event usually related to valve prolapse (between S1 and S2)
clicks
due to mitral or tricuspid valve prolapse
what heart sound occurs between between S1 and S2
clicks
where S1 and S2 sounds are the fusion of 2 valve closing
Separation (MV then TV or AoV then PV) causes splitting
Splitting
What does an S3 sound indicate
vibrations during early diastolic filling
normal in large animals but in small animals it is a sign of heart failure due to rapid filling that abruptly stops
What does an S4 sound indicate
vibrations during late diastolic filling (after atrial contraction)
normal in large animals but in small animals means related to a stiff or poorly relaxing ventricle that is filled rapidly after atrial contraction
What might be the cause for a mid-systolic click
prolapse of the mitral or tricuspid valve
what might cause split heart sounds
1) sometimes only appreciated as the normal heart sound lasting longer than expected
2) often related to respiration (prolongation of P2 with right sided filling)
a prolonged audible vibration during a normally silent period of cardiac cycle
murmur
*often a sign of underlying heart disease but innocent and physiological murmurs can occur
vibrations become audible when blood flow becomes turbulent due to:
1) Increased velocity
2) Decreased viscosity
3) Flow into a large receiving chamber
Proto
early murmur (protosystolic)
meso
mid murmur (mesosystolic)
tele
late murmur (telesystolic)
holo
throughout phase murmur
(holodiastolic)
How are murmurs graded
on a 6 tier scale
1: nearly imperceptible. may be heart with very careful auscultation in quiet environment, always focal
2: heard readily but very soft; always focal
3: Heard readily, moderate intensity, usually regional (can only be heard in several auscultatory regions)
4: heard readily, loud, and usually radiates widely (can be heard in most or all auscultatory region of the heart) but without palpable thrill
5: Heard readily loud and associated with precordial thrill, but the murmur is not heard with the stethoscope lifted off the surface of the thorax
6: Heard readily, loud, associated with precordial thrill, murmur remains audible with stethoscope lifted 1 cm off the surface of thorax
Rate the murmur:
nearly imperceptible. may be heart with very careful auscultation in quiet environment, always focal
grade 1 murmur
Rate the murmur: heard readily but very soft; always focal
grade 2 murmur
Rate the murmur: Heard readily, moderate intensity, usually regional (can only be heard in several auscultatory regions)
grade 3 murmur
Rate the murmur: heard readily, loud, and usually radiates widely (can be heard in most or all auscultatory region of the heart) but without palpable thrill
grade 4 murmur
Rate the murmur: Heard readily loud and associated with precordial thrill, but the murmur is not heard with the stethoscope lifted off the surface of the thorax
grade 5 murmur
Rate the murmur: Heard readily, loud, associated with precordial thrill, murmur remains audible with stethoscope lifted 1 cm off the surface of thorax
grade 6 murmur
murmurs that occur between or obscuring S1 and S2
systolic murmur
murmurs that occur after S2 often dies off slowly
diastolic murmur
Continuous murmurs
murmurs with same sound quality, variable intensity
To-and-Fro murmurs
murmurs with separate systolic and diastolic murmurs (windshield wipers)
What are the 6 ‘S’ that suggest an innocent heart murmur
Sensitive (changes with positiion/respiration)
Short duration (protosystolic)
Single (no associated clicks/gallops
Small (limited to a small area, does not radiate)
Soft (low amplitude)
Systolic (limited to systole)
what might scratching sounds indicate
friction/grating between two pericardial layers
heard most often in large animals with inflammatory pericarditis
is a vibratory sound produced by narrowed large air passages usually worse during inspiration. it usually reflects large airway obstruction (larynx, trachea, etc)
stridor
harsh, snoring sound, usually inspiratory. it is typically related to soft palate obstruction or secretion in upper airway
-nasopharyngeal foreign body or nasopharyngeal stenosis
stertor
abnormal breath sounds that reflect small airway collapse, usually expiratory and high pitched
-ex: asthma
wheezes
harsh, popping sounds related to rapid opening of collapse airways or alveoli
-fluid or fibrosis
crackles
T/F: you cannot tell left versus right on a lateral radiograph
True
VD radiograph
a radiograph view that was taken with the animal lying on their back (dorsorecumbency)
DV radiograph
a radiograph view that was taken with the animal lying on their sternum (sternalrecumbency)
What are the differences between VD and DV radiograph views
VD: diaphragmatic crura are more obvious and better for the lungs
DV: better for CV structures, pleural fluid more obvious, though it obscures the structures
What radiograph view makes the 2 diaphragmatic crura more obvious
VD
DV- looks more like a dome instead
What radiograph view is preferred for lung evaluation
VD
Is DV or VD better for evaluating cardiovascular structures
DV
Is DV or VD preferred for lungs
VD
is pleural fluid more obvious on DV or VD
DV, though it obscures the structures
What are some differences in thoracic radiographs in cats versus dogs
Cats:
1) Heart lays more horizontal (dog is more vertically oriented)
2) Thorax is more triangular
3) Elongated vertebral bodies and sternebrae
4) Finer fibers
5) often more lung between cardiac silhouette and diaphragm
On radiograph you see a bulge toward the craniodorsal aspect of the cardiac silhoutte (lateral projection) and a dilation in the 9 to 11 o’clock position (DV or VD)
Right Atrial Enlargement
What would you see on radiograph of an animal with right atrial enlargement
Lateral: bulge toward the craniodorsal aspect of the cardiac silhoutte
DV/VD: dilation in the 9-11 o’clock position
On VD/DV radiography, the left side of the screen is always the
right side of the animal
What would you see on radiograph of an animal with right ventricular enlargement (ex: from pulmonary valve stenosis)
Lateral: wider appearance to cardiac silhouette
DV/VD: displacement of the cardiac silhouette to the right in the 6 to 9oclock position creating the reversed D sign
On lateral radiograph you see a wider appearance to the cardiac silhouette and on DV/VD you see displacement of the cardiac silhouette to the right in the 6-9o’clock position (creating a reverse D). What is likely the cause
Right ventricular enlargement (could be from pulmonary valve stenosis)
orthogonal radiographs
radiograph obtained from 90 degrees from the original view
(ex: VD/DV)
Upon VD/DV radiography you notice enlargement at the 1-2 oclock position. What could be occuring
pulmonary artery is enlarged
-pulmonary hypertension possibly
left and right pulmonary artery branches often appear dilated relative to their corresponding vein
What do you see on radiography of a patient with an enlarged pulmonary artery (could be from pulmonary hypertension)
Upon VD/DV radiography you notice enlargement at the 1-2 oclock position
What is seen on radiography of a patient with left atrial enlargement (could be from mitral stenosis)
Lateral: bulge at the caudal cardiac waist- backpack sign
Vertebral left atrial score >2.3
VD/DV: spreading of bronchi (bow-legged cowboy)
double opacity sign as the enlarged left atrium extends caudally
What vertebral left atrial score is indicative of left atrial enlargement
> 2.3
you will see the spreading of bronchi on DV/VD radiography with
left atrial enlargement
-it sits fairly centrally
(bow-legged cowboy)
Upon lateral radiography you see a bulge at the caudal cardiac waist and upon VD/DV you see spreading of the bronchi an a double opacity sign. What are you suspicious of
left atrial enlargement (ex: mitral stenosis)
What would you see on radiograph in a dog with mitral stenosis
left atrial enlargement
Lateral: bulge at the caudal cardiac waist- backpack sign
Vertebral left atrial score >2.3
VD/DV: spreading of bronchi (bow-legged cowboy)
double opacity sign as the enlarged left atrium extends caudally
What would you see on radiography of a dog with pulmonary valve stenosis
right ventricular enlargement
Lateral: wider appearance to cardiac silhouette
DV/VD: displacement of the cardiac silhouette to the right in the 6 to 9oclock position creating the reversed D sign
What might you see on radiography of a dog with subaortic stenosis
Left ventricular enlargement
Lateral: appears taller on radiography (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)
VD/DV: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock
On lateral radiograph you see taller heart (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)
on VD/VD: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock
Left ventricular enlargement (ex: subaortic stenosis)
What are the signs of left ventricular enlargement on radiography
Lateral: appears taller on radiography (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)
VD/DV: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock
What might you see on radiography of a patient with aortic enlargement
could be from small PDA
bulge at cranial cardiac waist on lateral (more cranial than the right ventricle)
prominence from 11 to 1 o’clock on DV/VD
often appears as widening of cranial mediastinum
dilation contiguous with descending aorta
Upon lateral radiography you see bulge at cranial cardiac waist on lateral and then prominence from 11 to 1 o’clock on DV/VD, often appears as widening of cranial mediastinum
What is your diagnosis
aortic enlargement
-could be from a small PDA
How do you take a vertebral heart score
Line from: ventral aspect of corina to the apex of heart (long axis)
Line from the widest part of the cardiac silhouette
compare this to the number of vertebral bodies starting at the 4th vertebral body
add up the short and long axis to get the total score
normal = 9.7 +/- 0.5
What is the normal vertebral heart score
9.7 +/- 0.5
vertebral left atrial size (VLAS)
an alternate measure of cardiac enlargement specific to the left atrium
-ventral carina to the caudal left atrium border at the level of the caudal vena cava
A score of >2.3 vertebral bodies predicts an enlarged LA
what lines do you draw for vertebral left atrial size (VLAS)
ventral carina to the caudal left atrium border at the level of the caudal vena cava
What are some issues with VHS (vertebral heart score) and VLAS ( Vertebral left atrial size)
Hemivertebrae
Structures (fat summating with cardiac silhouette
Breed differences (ex: bulldog 12.7 +/- 1.7 is normal for breed)
On VD/DV radiograph, veins are
ventral and central
on lateral radiograph, veins are
ventral and centra;
bronchial lung pattern
increased opacity of airway walls
fluid or cellular material in bronchial wall, lumen, or peribronchial space
-usually related to airways inflammation
looks like sponge
pathologic dilation of bronchi, usually related to chronic inflammatory and damage to the bronchial wall
bronchiectasis
interstitial unstructured pattern
increased fluid/cells in the pulmonary interstitial space on radiograph
unstructured is a diffuse, hazy appearance obscuring your ability to see normal vessels
what are your differentials for pulmonary nodules in radiograph
-Tumor
-Granuloma
-Abscess
-Cyst
-Cavitary nodules: lungwomrs, pgas producing abscess, atypial neoplasia
a pattern on radiography where the alveoli are filled with fluid/debris
appearance is comparable to trees in snowstorm.
alveolar pattern
a pattern on radiography where there is a clear delineation between the alveolar pattern in the right middle lung lobe and the aerated right cranial lung lobe
lobar sign
air filled nodules on radiography
less common than soft tissue nodules.
differentials include lungworms, gas-producing abscess or atypical neoplasia
cavitary lung nodules
what does a pneumothorax look like on radiography
the heart will appear elevated from the sternum as it falls to the side of collapse when in lateral
no lung markings -> atelectatic (collapsed) lung
What does it mean when on lateral radiography you see the heart is elevated from the sternum
pneumothorax
what will pleural effusion look like on radiography
fluid opacity surrounding the lungs causing pleural fissure lines and obscuring our ability to view the heart
You see fluid opacity surrounding the lungs causing pleural fissure lines and obscuring our ability to view the heart. What likely is occuring
pleural effusion
Why might there be decreased lung vasculature on radiography
tetralogy of fallot
pulmonary hypoperfusion due to shunt
why might there be increased lung vasculature on radiography
advanced heart worm disease
pulmonary arterial enlargement
higher frequency probes have
higher resolution and lower penetration
7-12 MHz probes are used in cats and small dogs
lower frequency probes have
lower resolution but higher penetrations
3-5Hz= large dogs and horses
what are the basic physics of ultrasound
1) Sound waves travel through a medium and are either reflected, scattered, or absorbed
2) Sound waves are reflected back when there is a difference in density between tissues
What can echocardiography tell you about the structure and function of the heart
Structure
1) remodeling- eccentric and concentric hypertrophy
2) Valve morphology- dysplasia, degeneration, infection
3) Defects- vascular and septal
4) Pericardial disorders
5) Heartworms, neoplasia, thrombus
Function
1) Systolic and diastolic
2) Valvular dysfunction- prolapse, stenosis, insufficiency
3) Pericardial tamponade
4) Abnormal blood flow
What are the two positions you echo an animal in
Right parasternal image.
1) right 3rd and 6th intercostal spaces between sternum, and costochondral junctions
Left parasternal image:
1) Left caudal (apical) location between the left 5th and 7th intercostal spaces and close to sternum
2) Left cranial location located between the left 3rd and 4th intercostal spaces between the sternum and costochondral junction
right 3rd and 6th intercostal spaces between sternum, and costochondral junctions
right parasternal images
see:
1) long axis 4 chamber view
2) fan to see long axis LV outflow view with aorta
3) short axis. Fan from A (all LV) then fanning up with increasing RV crescent
Left caudal (apical) location between the left 5th and 7th intercostal spaces and close to sternum
left caudal (apical) parasternal
1) right at apex looking up for 4 chamber inflow view (RV,LV,RA,LA) and 5 chamber LV outflow view (RV, LV, RA,Ao, LA)
2) Long axis 2 chamber view LV, LA, Left auricle to look at left auricle in cats
Left cranial location located between the left 3rd and 4th intercostal spaces between the sternum and costochondral junction
Left cranial parasternal images
1) Short axis view
2) Long axis view to view Aorta, R aurcle, Pulmonary valves
why might you want to look at the long-axis 2 chamber view in left caudal parasternal for a cat
you want to look at the left auricle bc of saddle thrombus
what do you want to assess of right parasternal long axis 4 chamber view
1) Interatrial and ventricular septum should not be bowed
(Higher pressure on one side)
2) Interventricular septum and LV free wall should be similar in thickness
3) RV free wall should be 1/2 the LV free wall thickness
The interventricular septum should be __________ as the LV free wall and the LV free wall should be ______ than the RV
the same
twice the thickness
The RV chamber should be ________ dimension of the LV in right parasternal long axis 4 chamber view
1/3
Upon right parasternal long axis 4 chamber view, you see that the LV and LA is dilated with decreased systolic function. What is the diagnosis
Dilated cardiomyopathy (DCM)
On the right parasternal long axis 5 chamber view, the left atrium is ________ the size of the aorta
1:1
What does it mean when on right parasternal long axis 5 chamber view you notice the interventircular septum extendind into the LV outflow tract
there is some sort of subarotic ridge or hypertrophy
Subaortic stenosis
On right parasternal long axis 5 chamber view, the RV chamber should be _____ dimension of LV
1/3
How do you diagnose subaortic stenosis on right parasternal long axis 5 chamber view
you see the interventricular septum extending into the LV outflow tract
(subaortic ridge/tunnel)
LV concentric hypertrophy and LV dilation
what should you see on right patasternal short axis view of the left ventricle
1) Symmetrical papillary muscles
2) Uniform shortening
3) No flattening of the interventricular septum (pressure of RV pushing down)
4) Irregularities on the RV side of interventricular septum are normal
*may see RV papillary muscles
-Mushroom view
when do you see the mushroom view on echo
right parasternal short axis views of the left ventricle
what does a squished mushroom view on right parasternal short axis view of the left ventricle mean
there is a pressure overload leading to right ventricular hypertrophy pushing on the left ventricle and flattening of the IVS
two differentials
1) Pulmonary valve stenosis
2) pulmonary hypertension
Upon doing right parasternal short axis view of the left ventricle you see flattening of the interventricular septum and right ventricular concentric hypertrophy. what are two possible diagnosis
1) Pulmonary valve stenosis
2) Pulmonary hypertension
What should you see when doing right parasternal short axis view of the mitral valve
fish mouth view
1) assess mitral valve leaflets for thickening or prolapse
2) Uniform shortening
3) no flattening of the IVS
UPon right parasternal short axis view of the mitral valve (fish mouth) you see thickened mitral valve leaflets and prolapse of anterior leaflet. What is your diagnosis?
Degenerative mitral valve disease
What should you assess on right parasternal short axis view of the base
Assess
1) Left atrial size (Left atrium:Aorta ratio) normal is <1.3-1.5
2) Aortic valve cusps for excursion, thickness, or lesions
What is a normal LA:Ao ratio on right parasternal short axis views of the heart base
<1.3-1.5
What might you see on right parasternal short axis view of the base in a patient with degenerative mitral valve disease
1) Enlarged Left Atrium (La:Ao = >1.3-1.5)
What should you asssess when right parasternal short axis views of RVOT
1) Aorta and pulmonary artery should be similar in diameter
2) Right and left branch pulmonary arteries
What should you assess on left caudal (apical) four chamber view
1) Mitral and tricuspid valve leaflets for thickening, lesions, prolapse/flail
2) Right atrium should be smaller than left atrium (at this view)
*Used for volume assessment to calculate ejection fraction (EF)
What is a good view to compare the two atrium sizes
left caudal (apical) 34 chamber view
*the right atrium should be smaller than the left atrium
What is a good view to assess and calculate the ejection fraction (EF)
Left caudal (apical) four chamber view
it should be greater than 50%
How do you determine the ejection fraction on echo
1) Left caudal (apical) four chamber view
End diastolic volume-End Systolic Volume / End Diastolic Volume
Normal EF >50%
What is a good echo view to assess the aortic valve and left ventricular outflow velocity
Left caudal (apical) five chamber view (RV, RA, LV, LA, Ao)
What should you assess on the left caudal (apical) five chamber view
1) Aortic valve and left ventricular outflow velocity
2 Mitral valve for thickening, lesions or prolapse/flail
What echo view should you do to assess for right auricular masses
Left cranial long axis views- right atrium and auricle
Why might you want to use a left cranial long axis view of the right atrium and auricle
to look at the auricle for right atrial/aurciular mass (hemangiosarcoma) or to assess pericardial effusion
What view is helpful for looking at the left auricle in cats (clots of blood that could lead to thrombi)
left cranial short axis view of left auricle
what is M-mode
motion mode echocardiography
cursor is placed through 2D image and the location of each interface is represented by a line, which provides information about its temorpral locaton
On M-Mode echo, the depth is
expressed vertically on image
On M-mode echo, time is
expressed horizontally on image
What is normal fractional shortening (FS) from M-mode
Dog (normal): 30-46%
Cat (normal): 40-65%
technique that displays blood flow measurements graphically
-velocity of blood flow
-duration of flow
-directionality of flow
-quantification of blood flow
spectral dopplers
measures velocity along the entire path of the ultrasound beam: __________
measures velocity at a specific location (limited to maximum range of velocities measured: ____________
continuous wave doppler
pulsed wave doppler
What is the application of measuring vessel velocity with spectral doppler
estimate the pressure from velocity of blood flow through the heart
Simplified Bernoulli equation
P=4v^2
How do you determine pressure of a specific area on echo
use spectral doppler to determine the flow velocities then use the simplified Bernoulli equation
P=4v^2
allows visualization of flow direction and velocity within a user defined area
Color flow doppler
On color flow doppler, what color is blood flow away from the probe
blue
on color flow doppler, what color is blood flow towards the probe
red
What do green or yellow colors on color flow doppler mean
areas of high flow turbulence (abnormal)
