Normal/ Abnormal Cardiovascular system Flashcards
Views when evaluating the heart
Standard images: lateral and DV
Then use ECG
Dog shape and size of cardiac silhouette
Deep chested (doberman): 2.5 ICS
Standard/ Intermediate- 2.5 ICS
Shallow/ wide chested (brachy): 3-3.5 ICS
Cat shape and size of cardiac silhouette
2 ICS
Pulmonary vasc in the lateral view
Cranial lobar vessels (arteries and veins)
Compare to 3rd or 4th rib for size
Vertebral heart score (VHS)
Long axis: bottom of carina to cardiac apex
Short axis: widest distance perpendicular to the long axis line @ cd. vena cava
Compare to ribs and combine
Pulmonary vasc. in VD or DV view
Cd. lobar arteries and veins
Compare to 9th rib
Normal VHS ranges
Dogs: 8.7-10.7
Cats: 6.9-8.1
evaluates cardiomegaly
What are the causes of loss of cranial cardiac waist
Enlarged RA, MPA or aortic arch
Normal position of the carina
Upper 1/3 of thorax
What causes elevation of the carina?
Left sided heart dz (mitral regurgitation/ insufficiency or left ventricular dz/ aortic stenosis)
Right sided heart dz
Hypovascular lung field
Arteries and veins smaller than normal
From hypovolemia (blood loss, addisons, dehy), severe pulmonic stenosis and right to left shunting lesions (tetra of fallot and reverse PDA)
Blood flow with Tetralogy of fallot
- Overriding aorta (positioned over both ventricles over VSD)
- Ventricular septal defect (VSD)
- Severe pulmonic stenosis
Secondary: right ventricular enlargement
How is Tetralogy of fallot presented?
Cyanosis (unoxygenated blood going to the right side)
w/ right sided heart enlargement, hypo vascular lung field and enlarged MPA
Hypervascular lung field
Arteries and veins larger than normal
Artereis larger: HWD
Veins larger: MR (tricuspid insufficiency)
Arteries and veins larger: left to right shunting lesions (PDA, VSD, DCM, ASD)
What is seen with heartowrm dz
Enlarged arteries (MPA and lobar a.)
Hilar opacity from enlarged arteries to cd. lungs
Pulm. opacity from vasc. and interstitial patterns
Inverted backwards D with right sided cardiomegaly
Basic Echocardiography
Scan under the dog (lungs @ top)
LV (mushroom/ flower) landmark
Pulmonic stenosis rad findings
Normal vasculature
Loss of cranial cardiac waist
Enlarged MPA from post-stenotic dilation
PS
Valvular*, supravalvular and sub-valvular
If severe → pulmonary hypoperfusion, resp. failure, organ damage
Signalment for PS
Common in small breeds (english and french bulldog, boxer, beagle, keeshonds, terriers)
Aortic stenosis on rads
Normal vasculature
Loss of cranial cardiac waist
Enlarged aortic arch from post-stenotic dilation of the asc. aorta
Aortic Stenosis
Band of fibrous tissue beneath aortic valves
Subaortic stenosis (sub-valvular common)
Large breed dogs
Conditions involving AS
If valvular: infectious endocarditis»_space; valvular insufficiency
If severe → CHF (left)
Rad findings with left sided heart dz
Elevation of carina
Loss of cd. cardiac waist
Enlarged pulmonary veins
Cardiogenic pulm edema
Dx: mitral valvular dz, mitral regurgitation
Mitral regurgitation
Splitting of mainstem bronchi from enlarged LA displacing the left bronchus dorsally
Narrows l. bronchus from compression by LA
What other rad findings are seen with mitral regurg?
Enlarged cr. lobar vein
Enlarged LA on lat view on the midline (ST mass)
Hypertrophic Cardiomyopathy (HCM) is common in which breeds?
Maine coon, ragdoll, british shorthair, sphynx, chartreux and persian cats
HCM
Marked dilation of LA
Echocardiography to make a definitive dx
Thickened LV wall and papillary m hypertrophy
Dilated Cardiomyopathy
Dobermans*, boxers, Great danes, Shepherds, St. Bernards
Uncommon in cats due to correction of taurine deficiency in cat food
PDA
Blood leaves right side of heart → lungs → comes to left side and exits through aortic arch → communication between aortic arch and MPA (LEFT TO RIGHT SHUNTING LESION)
Chronic PDA (reverse PDA)
Pulmonary hypertension
Blood flow shifts to right to left (can’t get to lungs goes to aorta)
Cyanosis
Signs of right sided heart failure
Right-sided cardiomegaly
Hepatomegaly from venous congestion
Ascites (peritoneal effusion)
Enlarged cd. vena cava
Pulmonary Hypertension (PH)
↑ in P within the pulmonary vasculature
Most arterial
Pulmonary arterial hypertention causes
HWD, congenital shunts, idiopathic, vasculitis, and thromboembolic dz
Pulmonary venous hypertention (PVH)
Mitral valvular dz
Myocardial dz
Dz causing left sided heart failure
Rounding of the cardiac silhouette
Pericardial fat
Pericardial effusion
DCM
CHF
Pericardial diaphragmatic hernia
Pericardial Hernia
Congenital anomaly
Rads: silhouette signs, may not visualize abdominal contents in pericardial sac
