Lecture 6 8/23/24

Question 1

What are the characteristics of left-sided CHF?

Answer 1

-results in pulmonary venous hypertension
-causes pulmonary edema
-diagnosed through presence of radiographic pulmonary edema and evidence of substantive heart disease
-left ventricular dysfunction

Question 2

What are the characteristics of right-sided CHF?

Answer 2

-results in central venous hypertension
-causes cavitary effusions and peripheral edema
-diagnosed through presence of ascites +/- pleural effusion, presence of peripheral edema, and imaging evidence of substantive heart disease
-right ventricular dysfunction

Question 3

What are the indications for cardiac radiography?

Answer 3

respiratory distress and/or cough in patients known or suspected to have cardiac disease

Question 4

What are the goals of cardiac radiography?

Answer 4

-evaluate overall cardiac size and left atrium size
-evaluate lung/pleural space/intrathoracic vessels

Question 5

How can an enlargement of the left atrium/ventricle be identified on radiographs?

Answer 5

increase in the dorsoventral dimension

Question 6

How can enlargement of the right atrium/ventricle and/or pericardial effusion be identified on radiographs?

Answer 6

increase in the craniocaudal dimension

Question 7

How does the position of the trachea change in patients with enlarged left atrium/ventricle?

Answer 7

tracheal position is raised

Question 8

What is the vertebral heart score?

Answer 8

method of assessing heart size that compares the combined length and width of the heart to the length of the vertebrae

Question 9

What VHS score indicates cardiac enlargement?

Answer 9

-10.5 or greater in dogs
-8.3 or greater in cats

Question 10

When is VHS most useful?

Answer 10

therapeutic management of stage B mitral valve disease

Question 11

What causes the clinical signs associated with left-sided cardiac disease?

Answer 11

increased left atrial pressure

Question 12

What is left atrium size a surrogate measure of?

Answer 12

hemodynamic burden/left atrial pressure

Question 13

What findings on radiographs are indicative of left atrial enlargement?

Answer 13

lateral view:
-straightening of caudal border of cardiac silhouette
-separation of mainstem bronchi
VD view:
-separation of mainstem bronchi
-left appendage/auricle visible as a bulge
-double opacity

Question 14

What are the possible pulmonary patterns observed on radiographs?

Answer 14

-normal/clear vascular detail
-interstitial/vascular outlines blurred
-alveolar/air bronchograms

Question 15

What radiographic signs of heart failure are seen in cats?

Answer 15

-edema with a diffuse/patchy distribution
-pleural effusion

Question 16

What are the main uses of thoracic radiography?

Answer 16

-assessment of global heart size
-indirect assessment of cardiac performance
-non-invasive method for diagnosing left-sided CHF

Question 17

When is edema considered to be cardiogenic?

Answer 17

when the edema is associated with an enlarged heart

Question 18

What are the limitations of thoracic radiography?

Answer 18

-poor resolution of specific cardiac chambers
-cannot distinguish heart from pericardial space

Question 19

What is echocardiography?

Answer 19

use of reflected ultrasound in cardiac diagnosis

Question 20

What is provided by ECHO?

Answer 20

-visualization and precise measurement of specific cardiac chambers
-direct assessment of cardiac performance
-doppler/localization of flow disturbances