Normal/ Abnormal Cardiovascular system

Question 1

Views when evaluating the heart

Answer 1

Standard images: lateral and DV
Then use ECG

Question 2

Dog shape and size of cardiac silhouette

Answer 2

Deep chested (doberman): 2.5 ICS
Standard/ Intermediate- 2.5 ICS
Shallow/ wide chested (brachy): 3-3.5 ICS

Question 3

Cat shape and size of cardiac silhouette

Answer 3

2 ICS

Question 4

Pulmonary vasc in the lateral view

Answer 4

Cranial lobar vessels (arteries and veins)
Compare to 3rd or 4th rib for size

Question 5

Vertebral heart score (VHS)

Answer 5

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

Question 6

Pulmonary vasc. in VD or DV view

Answer 6

Cd. lobar arteries and veins
Compare to 9th rib

Question 7

Normal VHS ranges

Answer 7

Dogs: 8.7-10.7
Cats: 6.9-8.1
evaluates cardiomegaly

Question 8

What are the causes of loss of cranial cardiac waist

Answer 8

Enlarged RA, MPA or aortic arch

Question 9

Normal position of the carina

Answer 9

Upper 1/3 of thorax

Question 10

What causes elevation of the carina?

Answer 10

Left sided heart dz (mitral regurgitation/ insufficiency or left ventricular dz/ aortic stenosis)
Right sided heart dz

Question 11

Hypovascular lung field

Answer 11

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)

Question 12

Blood flow with Tetralogy of fallot

Answer 12

1. Overriding aorta (positioned over both ventricles over VSD)
2. Ventricular septal defect (VSD)
3. Severe pulmonic stenosis
   Secondary: right ventricular enlargement

Question 13

How is Tetralogy of fallot presented?

Answer 13

Cyanosis (unoxygenated blood going to the right side)
w/ right sided heart enlargement, hypo vascular lung field and enlarged MPA

Question 14

Hypervascular lung field

Answer 14

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)

Question 15

What is seen with heartowrm dz

Answer 15

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

Question 16

Basic Echocardiography

Answer 16

Scan under the dog (lungs @ top)
LV (mushroom/ flower) landmark

Question 17

Pulmonic stenosis rad findings

Answer 17

Normal vasculature
Loss of cranial cardiac waist
Enlarged MPA from post-stenotic dilation

Question 18

PS

Answer 18

Valvular*, supravalvular and sub-valvular
If severe → pulmonary hypoperfusion, resp. failure, organ damage

Question 19

Signalment for PS

Answer 19

Common in small breeds (english and french bulldog, boxer, beagle, keeshonds, terriers)

Question 20

Aortic stenosis on rads

Answer 20

Normal vasculature
Loss of cranial cardiac waist
Enlarged aortic arch from post-stenotic dilation of the asc. aorta

Question 21

Aortic Stenosis

Answer 21

Band of fibrous tissue beneath aortic valves
Subaortic stenosis (sub-valvular common)
Large breed dogs

Question 22

Conditions involving AS

Answer 22

If valvular: infectious endocarditis&raquo_space; valvular insufficiency
If severe → CHF (left)

Question 23

Rad findings with left sided heart dz

Answer 23

Elevation of carina
Loss of cd. cardiac waist
Enlarged pulmonary veins
Cardiogenic pulm edema
Dx: mitral valvular dz, mitral regurgitation

Question 24

Mitral regurgitation

Answer 24

Splitting of mainstem bronchi from enlarged LA displacing the left bronchus dorsally
Narrows l. bronchus from compression by LA

Question 25

What other rad findings are seen with mitral regurg?

Answer 25

Enlarged cr. lobar vein Enlarged LA on lat view on the midline (ST mass)

Question 26

Hypertrophic Cardiomyopathy (HCM) is common in which breeds?

Answer 26

Maine coon, ragdoll, british shorthair, sphynx, chartreux and persian cats

Question 27

HCM

Answer 27

Marked dilation of LA Echocardiography to make a definitive dx Thickened LV wall and papillary m hypertrophy

Question 28

Dilated Cardiomyopathy

Answer 28

Dobermans*, boxers, Great danes, Shepherds, St. Bernards Uncommon in cats due to correction of taurine deficiency in cat food

Question 29

PDA

Answer 29

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)

Question 30

Chronic PDA (reverse PDA)

Answer 30

Pulmonary hypertension Blood flow shifts to right to left (can't get to lungs goes to aorta) Cyanosis

Question 31

Signs of right sided heart failure

Answer 31

Right-sided cardiomegaly Hepatomegaly from venous congestion Ascites (peritoneal effusion) Enlarged cd. vena cava

Question 32

Pulmonary Hypertension (PH)

Answer 32

↑ in P within the pulmonary vasculature Most arterial

Question 33

Pulmonary arterial hypertention causes

Answer 33

HWD, congenital shunts, idiopathic, vasculitis, and thromboembolic dz

Question 34

Pulmonary venous hypertention (PVH)

Answer 34

Mitral valvular dz Myocardial dz Dz causing left sided heart failure

Question 35

Rounding of the cardiac silhouette

Answer 35

Pericardial fat Pericardial effusion DCM CHF Pericardial diaphragmatic hernia

Question 36

Pericardial Hernia

Answer 36

Congenital anomaly Rads: silhouette signs, may not visualize abdominal contents in pericardial sac