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��� Indication and Physical Examination of Cardiac Diseases�(Unit-2)�

Dr. Pallav Shekhar

Asstt. Professor

Veterinary Medicine, BVC

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Introduction

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Basic anatomy

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�Special Examination

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History

  • Age: Young and Old

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  • Breed: Congenital heart defects more common in specific breeds

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  • Large breed dog: More prone for dilated Cardiomyopathy

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  • Small breeds of dogs are susceptible to mitral regurgitation

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  • Siamese cats are prone to cardiomyopathy

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  • Weight: Pickwickian syndrome???

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History?

  • Helps to differentiate cardiac and respiratory problems
  • Exercise intolerance

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  • Nature of coughing.
  • Dyspnoea

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Indication of Cardiac Disease

  • Exercise intolerance, weakness, lethargy

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  • Cough, retch (or vomit)

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  • Faint/syncope

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  • Breathing difficulties, stridor

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  • Swollen abdomen

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  • Cyanosis

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  • Stunted/poor growth or weight loss

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Cont..

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  • Cyanotic mucous membranes may be due to decreased oxyhaemoglobin, e.g. severe respiratory tract disease or a right to left shunting congenital cardiac defect.

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  • A sluggish capillary refill time may indicate reduced cardiac output, i.e. forward failure.

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Cont..

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  • The jugular veins should be inspected and the neck will usually need to be clipped for adequate visualisation. Distension/pulsation is associated with right-sided congestive heart failure (CHF).

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  • Distended jugular veins in a dog with ascites will almost certainly mean the cause is cardiac in origin.

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Cont..

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  • The pulse usually reflects left ventricular stroke volume and contractility.

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  • A very weak pulse is found in dilated cardiomyopathy, but not necessarily so with mitral valve disease.

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Physical Examination

  • Posture

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  • Rate and rhythm of respiration

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  • Dependent Ventral edema

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Cardiac Examination

  • Examination of Head
  • Examination of Neck
  • Palpation
  • Percussion
  • Auscultation

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Palpation

  • PMI: Left Side between 4th and 6th Intercostal spaces.
  • Shifting of PMI
  • Decrease Intensity
  • Thrills (Large Cardiac murmur)
  • Check for ascites
  • Check for hepatomegaly splenomegaly
  • Skin for anasarca
  • Femoral pulse: Rate and Rhythm

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Pulse

  • Pulse for every heart beat

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  • Pulse deficits: Arrhythmias indicating incomplete ventricular filling

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  • Weak pulse

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  • Water hammer pulse

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Percussion

  • Elicits a hollow sound over the lungs

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  • Elicits a dull sound over solid structures

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Auscultation

  • Most Helpful
  • Animal should be standing position

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P= Pulmonic area

A= Aortic area

M= Mitral area

T=Tricuspid area

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Area of Auscultation

Area

Equines

Ruminants

Base

From 2nd to 6th intercostal space

From 3rd to 6th rib

Apex

Half an inch from the last sternal segment

One inch from the diaphragm

Posterior border

Opposite to the 6th rib

Opposite to the 5th rib

Left surface

Composed of left ventricle and extends from 3rd to 6th rib

Extends from 3rd to 4th rib

Right surface

Extends from 3rd to 4th rib

Not examined

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VERTEBRAL HEART SCORE TEST

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The average VHS in the dog is 9.7v( 8.5-10.5v)

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THANK YOU

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