Veterinary Cardiology Quiz

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Questions and Answers

What is the normal Vertebral Heart Scale (VHS) value range for dogs?

  • 10.5 +/- 0.5
  • 8.2 +/- 0.5
  • 9.7 +/- 0.5 (correct)
  • 12.0 +/- 0.5

Which method is identified as superior for identifying left atrial enlargement in dogs with MMVD?

  • Modified Vertebral Left Atrial Size (M-VLAS) (correct)
  • Thoracic Radiography
  • Vertebral Heart Scale
  • Vertebral Left Atrial Size (VLAS)

What is the normal range for the Vertebral Left Atrial Size (VLAS) in dogs?

  • 1.4 - 2.2 v (correct)
  • 1.0 - 1.5 v
  • 1.5 - 2.0 v
  • 2.0 - 2.5 v

How wide should the cardiac silhouette be measured in lateral view in dogs?

<p>2.5 – 3.5 intercostal spaces wide (A)</p> Signup and view all the answers

Which of the following questions is NOT part of the basic evaluation for cardiac size interpretation?

<p>Is there a history of cardiac disease? (B)</p> Signup and view all the answers

What is a common sign of left-sided congestive heart failure in cats?

<p>Pulmonary edema (B)</p> Signup and view all the answers

Which of the following is NOT associated with right-sided congestive heart failure?

<p>Peripheral edema (C)</p> Signup and view all the answers

Which acquired condition can lead to left-sided cardiomegaly?

<p>Endocarditis (C)</p> Signup and view all the answers

What is a common indicator of right-sided cardiomegaly?

<p>Hepatic congestion (A)</p> Signup and view all the answers

Which of the following congenital conditions is linked to left-sided cardiomegaly?

<p>Patent ductus arteriosus (B)</p> Signup and view all the answers

Which pattern describes the interstitial to alveolar edema seen in left-sided heart failure?

<p>Unstructured interstitial to alveolar pattern (D)</p> Signup and view all the answers

Which of the following is a differential diagnosis for left-sided cardiomegaly?

<p>Hypertrophic cardiomyopathy (B)</p> Signup and view all the answers

In cases of left-sided heart failure, what might contribute to pleural effusion?

<p>Mitral valve degeneration (C)</p> Signup and view all the answers

What is the normal Vertebral Heart Score (VHS) range in cats?

<p>7.5 +/- 0.3 (D)</p> Signup and view all the answers

Which projection best visualizes the cranial lobar pulmonary vessels?

<p>Lateral projections (B)</p> Signup and view all the answers

In the lateral view of the clock face analogy, which chamber is located approximately at the 12:00-2:00 position?

<p>Left Atrium (B)</p> Signup and view all the answers

What shape is typically observed in a normal cat's heart on VD or DV projection?

<p>Valentine-shaped heart (B)</p> Signup and view all the answers

What effect does aging have on cardiac measurement in cats?

<p>Increased tilt due to a 'lazy heart' (D)</p> Signup and view all the answers

What does the position 1:00-2:00 indicate in the DV view of the clock face analogy?

<p>Main Pulmonary Artery (B)</p> Signup and view all the answers

In the lateral view, which chamber is located at the 5:00-9:00 position?

<p>Right Ventricle (B)</p> Signup and view all the answers

What condition is suggested by enlarged pulmonary veins in cats?

<p>Left-sided cardiac failure (C)</p> Signup and view all the answers

How is the width of the heart measured in relation to the VHS?

<p>Perpendicular to the length from the tracheal bifurcation (D)</p> Signup and view all the answers

Which of the following chamber positions does NOT correspond to the lateral view of the clock face analogy?

<p>Main Pulmonary Artery at 3:00-5:00 (D)</p> Signup and view all the answers

What can cause enlarged pulmonary arteries in cats?

<p>Pulmonary hypertension (A)</p> Signup and view all the answers

Where is the Left Ventricle positioned in the DV view according to the clock face analogy?

<p>3:00-5:00 (A)</p> Signup and view all the answers

In the lateral view, what is located between the positions of the Left Atrium and Left Ventricle?

<p>Right Ventricle (A)</p> Signup and view all the answers

What is a major challenge in determining cardiac chamber enlargement in cats?

<p>Variation in heart shape (C)</p> Signup and view all the answers

Which structure is located at the 9:00-11:00 position in the DV view?

<p>Right Atrium (D)</p> Signup and view all the answers

What does the AA position at 11:00-1:00 represent in the clock face analogy?

<p>Aortic Arch (B)</p> Signup and view all the answers

What is the position of the left ventricle in the cardiovascular system viewed from the right lateral aspect?

<p>2:00-5:00 (C)</p> Signup and view all the answers

In a dorsoventral (DV) view of the cardiovascular system, which structure lies to the left of the midline?

<p>Apex of heart (A)</p> Signup and view all the answers

What is the location of the right ventricle in the cardiovascular system when viewed from the right lateral side?

<p>5:00-9:00 (C)</p> Signup and view all the answers

Which chamber of the heart is indicated to occupy the 12:00-2:00 position in the right lateral view?

<p>Left atrium (C)</p> Signup and view all the answers

What position corresponds to the left atrium when looking at the cardiovascular system in the DV view?

<p>12:00-2:00 (C)</p> Signup and view all the answers

Which structure is primarily observed at the apex of the heart in the right lateral view?

<p>Left ventricle (D)</p> Signup and view all the answers

In the right lateral view, which chamber has the time frame of 2:00-5:00?

<p>Left ventricle (B)</p> Signup and view all the answers

Which of the following views shows the left atrium in the 12:00-2:00 position?

<p>Dorsoventral view (D)</p> Signup and view all the answers

What is a common radiographic finding associated with left-sided heart failure in adult small breed dogs?

<p>Enlargement of the left side of the heart (C)</p> Signup and view all the answers

Which condition is characterized by dilated and tortuous pulmonary arteries with potential mineralizations?

<p>Canine heartworm disease (B)</p> Signup and view all the answers

What is a classic radiographic finding indicative of a patent ductus arteriosus (PDA)?

<p>Three knuckles sign (A)</p> Signup and view all the answers

What is a common consequence of congenital cardiac shunting defects?

<p>Left-to-right shunting (A)</p> Signup and view all the answers

Which of the following is a radiographic finding in a cat with ventricular septal defect (VSD)?

<p>Uni- or bilateral heart enlargement (D)</p> Signup and view all the answers

What is the focus of treatment for pulmonic stenosis?

<p>Balloon valvuloplasty (A)</p> Signup and view all the answers

Which cardiac condition can lead to a 'boot-shaped heart' appearance on radiographs?

<p>Tetralogy of Fallot (C)</p> Signup and view all the answers

What can result from left-sided cardiomegaly associated with left-to-right PDA?

<p>Pulmonary overcirculation (A)</p> Signup and view all the answers

Which condition does NOT result in left-sided cardiomegaly?

<p>Right-sided cardiomyopathy (C)</p> Signup and view all the answers

What could indicate congestive heart failure in young patients with congenital defects?

<p>Increased pulmonary vascular markings (B)</p> Signup and view all the answers

Flashcards

Clock Face Analogy

A method used to describe the location of heart chambers and major blood vessels on a radiograph by using a clock face analogy. The clock's numbers represent approximate positions, helping to visualize and identify specific structures.

Left Atrium (LA) Position on Lateral View

The left atrium is typically visualized in the lateral view of the heart between the 12:00 and 2:00 positions on the clock.

Left Ventricle (LV) Position on Lateral View

The left ventricle is located on the lateral view between the 2:00 and 5:00 positions.

Right Ventricle (RV) Position on Lateral View

The right ventricle appears on the lateral view between the 5:00 and 9:00 positions.

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Aorta (Ao) Position on DV/VD View

The aorta (Ao) is located in the DV/VD view between the 11:00 and 1:00 positions.

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Main Pulmonary Artery (MPA) Position on DV/VD View

The main pulmonary artery (MPA) is found in the DV/VD view between the 1:00 and 2:00 positions.

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Left Auricle (LAu) Position on DV/VD View

The left auricle (LAu) appears in the DV/VD view between the 2:00 and 3:00 positions.

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Left Ventricle (LV) Position on DV/VD View

The left ventricle (LV) in the DV/VD view is located between the 2:00 and 5:00 positions.

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Left Auricle (DV View)

The left auricle is a pouch-like structure located on the left side of the heart, specifically at the 2:00-3:00 o'clock position in a dorsoventral (DV) view.

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Left Atrium (Right Lateral)

The left atrium (LA) is located on the left side of the heart, occupying the 12:00-2:00 position in a right lateral view.

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Left Ventricle (Right Lateral)

The left ventricle (LV) is situated in the left side of the heart, positioned between 2:00-5:00 in a right lateral view.

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Right Ventricle (Right Lateral)

The right ventricle (RV) occupies the right side of the heart, from 5:00-9:00 in a right lateral view.

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Left Ventricle (DV View)

The left ventricle is located in the heart, positioned between 2-5 o'clock in a dorsoventral (DV) view.

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Heart Apex Location

The heart's apex, the most pointed part, lies on the left side of the midline, slightly off center.

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Right Ventricle (DV View)

The right ventricle is located on the right side of the heart, occupying the 5 - 9 o'clock position in a dorsoventral (DV) view.

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Vertebral Heart Scale (VHS)

The measurement of the heart's size relative to the vertebral bodies, specifically from the carina to the apex.

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Vertebral Left Atrial Size (VLAS)

A measurement of the left atrium's size using vertebral bodies, from the carina to the caudal vena cava.

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Modified Vertebral Left Atrial Size (M-VLAS)

A modified version of VLAS, adding the height of the left atrium to the length measurement, improving accuracy for detecting enlarged left atrium.

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Pericardial Fat

A condition where the heart appears larger than normal due to excessive fat surrounding it, mimicking cardiomegaly.

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Cardiac Size Evaluation in Dogs

A measurement used to assess the size of the heart in canine patients, employing the Vertebral Heart Scale (VHS), Vertebral Left Atrial Size (VLAS), and Modified Vertebral Left Atrial Size (M-VLAS) methods.

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CATS (Cardiac Size Evaluation)

A method for assessing cardiac size in cats, utilizing measurements in lateral and dorsoventral projections.

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VHS (Vertebral Heart Score)

A scoring system used to evaluate cardiac size in cats, using the number of vertebral bodies covered by the heart's length and width.

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Cardiac Shape in Cats

In cats, heart shape is more important than specific chamber enlargement due to the difficulty in identifying individual chambers.

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Valentine-Shaped Heart

A specific heart shape seen on radiographs, often indicating bi-atrial enlargement or severe left atrial enlargement.

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Lazy Heart

A common finding in older cats, where the heart appears more tilted due to age-related changes.

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Redundant Aorta

A normal anatomical variation in cats where the aorta appears enlarged on radiographs.

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Pulmonary Vessels

The size of pulmonary vessels is measured on radiographs to assess for abnormalities in blood flow.

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Enlarged Pulmonary Vessels

Enlarged pulmonary arteries and veins can indicate conditions like heartworm disease, pulmonary hypertension or left to right shunting defects.

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Left-Sided Cardiomegaly

Enlargement of the left side of the heart, often associated with conditions affecting the left ventricle or mitral valve. It can lead to fluid buildup in the lungs (pulmonary edema) and systemic circulation.

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Right-Sided Cardiomegaly

Enlargement of the right side of the heart, commonly caused by issues affecting the right ventricle, such as tricuspid valve disease or heartworm disease. It may lead to fluid accumulation in the abdomen and legs.

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Left-Sided Congestive Heart Failure (CHF)

A type of heart disease in which the left ventricle is unable to pump blood effectively, leading to fluid buildup in the lungs and other tissues.

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Right-Sided Congestive Heart Failure (CHF)

A type of heart disease in which the right ventricle is unable to pump blood effectively, leading to fluid buildup in the abdomen and legs.

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Mitral Valve Degeneration

A common heart disease in dogs, typically caused by degeneration of the mitral valve, leading to leakage of blood back into the left atrium.

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Cardiomyopathy

A group of heart diseases characterized by thickening of the heart muscle, making it difficult for the heart to pump blood effectively.

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Aortic Stenosis

An abnormal narrowing of the aorta, the main artery that carries blood from the heart to the rest of the body.

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Patent Ductus Arteriosus (PDA)

A congenital condition in which the ductus arteriosus, a blood vessel connecting the aorta to the pulmonary artery, does not close after birth.

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Enlarged Left-Side Heart

A heart condition where the left side of the heart enlarges, usually starting with the left atrium and left auricle, and later the left ventricle. It can eventually lead to left-sided heart failure and cardiogenic edema.

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Dilated Pulmonary Veins

Dilated veins in the lungs, indicating congestion. This often occurs due to impaired blood flow from the lungs back to the heart, a common symptom of left-sided heart failure.

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Cardiomyopathy (CM)

A heart condition where the heart muscle weakens, leading to reduced contractility. This may also involve the heart muscle growing larger (hypertrophy). It's common in larger breed dogs and cats.

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Dilated Cardiomyopathy

A type of cardiomyopathy where the heart chambers, particularly the left atrium, become dilated. This can sometimes involve the left ventricle and right-sided chambers depending on the specific cause. Enlarged pulmonary veins are also a characteristic.

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Hypertrophic Cardiomyopathy

A type of cardiomyopathy where the heart muscle thickens abnormally, primarily affecting the left ventricle. This can lead to restricted blood flow and heart failure.

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Septal Defect (Ventricular or Atrial)

An abnormal opening in the heart wall, either between the ventricles (ventricular septal defect) or between the atria (atrial septal defect). Initially, blood flows from left to right, causing pulmonary overcirculation.

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Pulmonic Stenosis (PS)

A narrowing of the pulmonary valve, creating turbulence in blood flow through the pulmonary artery. This can lead to undercirculation in the lungs and right-sided heart enlargement.

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Sub/Aortic Stenosis (SAS, AS)

A narrowing of the aortic valve, usually due to a fibrous band or thickening of the valve itself. This restricts blood flow from the left ventricle, leading to turbulent flow in the aorta and left-sided heart enlargement.

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Tetralogy of Fallot

A group of complex heart defects that can involve pulmonic stenosis, ventricular septal defect, misplacement of the aorta, right ventricular hypertrophy and more. Radiographically, the heart can appear boot-shaped (VD projection) and undercirculation of the lungs is common.

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Study Notes

Cardiovascular Radiography

  • This presentation covers cardiovascular radiography in veterinary medicine, focusing on identifying normal and abnormal features in thoracic radiographs of dogs and cats.
  • The presenter, Robson F. Giglio DVM, MSc, PhD, DACVR, is an Assistant Professor in Diagnostic Imaging at the University of Georgia's College of Veterinary Medicine.
  • Key goals include defining the cardiac silhouette, identifying the location of cardiac chambers and pulmonary vessels, and recognizing normal and abnormal heart sizes and chamber enlargements.
  • The presentation also includes common acquired and congenital cardiovascular diseases.
  • A review of normal radiographic anatomy, including the cardiac silhouette (heart + pericardial sac) and border effacement (inability to differentiate heart from pericardium on radiographs) is included, with breed-specific variations acknowledged.
  • A clock face analogy is used to describe the location of different heart chambers and large vessels on radiographs.
  • This method assists in identifying the cardiac silhouette and chambers on radiographs.
  • Evaluation techniques and methods like the Vertebral Heart Scale (VHS), Vertebral Left Atrial Size (VLAS) and Modified Vertebral Left Atrial Size (M-VLAS) are discussed for proper assessment of cardiac size.
  • Important considerations for evaluating feline cardiac radiographs include the potential for pericardial fat to mimic cardiomegaly and the variations in cardiac tilt with age.
  • The "lazy heart" and aortic knob are specific features to be aware of when evaluating feline patients.
  • Specific anatomical features in cats, such as atrial location differences, are covered.
  • Interpretation of pulmonary vessels (arteries and veins) and related measurements are detailed.
  • Various conditions causing enlarged pulmonary vessels (e.g., left-sided heart failure) or enlarged pulmonary veins (also left-sided heart failure) are addressed.
  • Cardiomegaly and its clinical radiographic presentation, including differentiated left-sided and right-sided enlargement are covered.
  • Radiographic signs for various cardiac conditions, such as left atrial enlargement, left ventricular enlargement, and right-sided cardiomegaly are highlighted.
  • Congestive heart failure (CHF) displays in lateral and VD radiographs, categorized according to side (left or right).
  • Different types of cardiomegaly and their differentiating characteristics are included.
  • A variety of congenital and acquired cardiac diseases in dogs and cats are presented. This includes mitral valve degeneration, cardiomyopathies (dilated and hypertrophic), heartworm disease, and congenital defects (PDA, VSD, PS, and Subaortic Stenosis) and related treatments.
  • Tables summarizing conditions presenting with CHF are included.

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