CVRS Approach to Diagnosis
Students should be able to:
❣️ ● heavier dogs are less likely to develop
murmurs associated with mitral valve
disease
★ take a history from the owner of a patient with cardiac disease ■ Large breed dogs (dobermans, Irish wolfhounds)
and recognise the significance of complaints likely to be related to develop dilated cardiomyopathy
cardiac disease and failure ○ Cats
★ carry out a clinical examination with special reference to ■ most frequently develop→myocardial diseases
abnormalities likely to arise as a consequence of cardiac disease ■ Most prevalent→hypertrophic cardiomyopathy
and failure ★ Sex
★ understand the cause, and significance of cardiac murmurs and ○ Some cardiac diseases have sex predilection
other abnormal heart sounds. ■ PDA in bitches
★ describe cardiac murmurs according to their point of maximal ■ Males have earlier onset with MVD and DCM
intensity, timing and intensity ★ Heart disease VS Heart Failure
★ formulate a list of differential diagnosis on the basis of clinical ○ any animal with a detectable abnormality of the heart can
findings be said to have heart disease
■ But a lot of animals will have heart murmurs /
Signalment heart rhythm disturbances without any outward
signs of abnormalities
★ Species ○ only animals demonstrating clinical signs of forward or
★ Age backward failure can be said to have heart failure
○ Congenital disease in young ■ Forward failure = inadequacy of output, low bp,
○ Some acquired diseases in aged animals collapse
■ as age increase - increase instances of heart ■ Congestive failure (backwards) = breathlessness,
murmurs exercise intolerance
★ Breed + types ○ Must distinguish that we will find patients with signs of
○ Many cardiac disease have breed/type association heart disease but not failure + there are patients that
○ Breed will present with signs of heart failure
■ Mitral valve disease affects small breed dogs ■ 2 distinct population of animals
particularly CKCS
● 75% of acquired heart disease
, History:
★ May not have clinical signs of diseases (to the point of signs of
heart failure)- common complaints
○ Dyspnoea - diff breathing
○ Cough
■ Associated with Cardiac disease in dogs (not
■
always)
● Air-hunger stance = dog keeping its
○ Exercise intolerance (Poor Performance)
airway as straight as it can
○ Lethargy
● BCS low
○ Ascites - fluid in peritoneal cavity
● Look anxious + high effort put into
○ Oedema - excess subcutaneous fluids
breathing
○ Syncope - loss of consciousness due to low BP
○ Respiratory effort and rate
○ Collapse
○ Mucous membranes
○ Weight loss
Differential Diagnosis:
★ Consider other systems
○ Respiratory
○ Neurological
○ Musculoskeletal ■
○ Metabolic ■ Normal = moist, salmon pink
● Oral often paler than conjunctiva
Physical Examination ■ Capillary Refill time
● Estimates tissue perfusion
★ Observation ● Blanch mucous membrane → Measure
○ Demeanor time taken for normal pink color to
appear
○ Normal CRT = <3 sec
Students should be able to:
❣️ ● heavier dogs are less likely to develop
murmurs associated with mitral valve
disease
★ take a history from the owner of a patient with cardiac disease ■ Large breed dogs (dobermans, Irish wolfhounds)
and recognise the significance of complaints likely to be related to develop dilated cardiomyopathy
cardiac disease and failure ○ Cats
★ carry out a clinical examination with special reference to ■ most frequently develop→myocardial diseases
abnormalities likely to arise as a consequence of cardiac disease ■ Most prevalent→hypertrophic cardiomyopathy
and failure ★ Sex
★ understand the cause, and significance of cardiac murmurs and ○ Some cardiac diseases have sex predilection
other abnormal heart sounds. ■ PDA in bitches
★ describe cardiac murmurs according to their point of maximal ■ Males have earlier onset with MVD and DCM
intensity, timing and intensity ★ Heart disease VS Heart Failure
★ formulate a list of differential diagnosis on the basis of clinical ○ any animal with a detectable abnormality of the heart can
findings be said to have heart disease
■ But a lot of animals will have heart murmurs /
Signalment heart rhythm disturbances without any outward
signs of abnormalities
★ Species ○ only animals demonstrating clinical signs of forward or
★ Age backward failure can be said to have heart failure
○ Congenital disease in young ■ Forward failure = inadequacy of output, low bp,
○ Some acquired diseases in aged animals collapse
■ as age increase - increase instances of heart ■ Congestive failure (backwards) = breathlessness,
murmurs exercise intolerance
★ Breed + types ○ Must distinguish that we will find patients with signs of
○ Many cardiac disease have breed/type association heart disease but not failure + there are patients that
○ Breed will present with signs of heart failure
■ Mitral valve disease affects small breed dogs ■ 2 distinct population of animals
particularly CKCS
● 75% of acquired heart disease
, History:
★ May not have clinical signs of diseases (to the point of signs of
heart failure)- common complaints
○ Dyspnoea - diff breathing
○ Cough
■ Associated with Cardiac disease in dogs (not
■
always)
● Air-hunger stance = dog keeping its
○ Exercise intolerance (Poor Performance)
airway as straight as it can
○ Lethargy
● BCS low
○ Ascites - fluid in peritoneal cavity
● Look anxious + high effort put into
○ Oedema - excess subcutaneous fluids
breathing
○ Syncope - loss of consciousness due to low BP
○ Respiratory effort and rate
○ Collapse
○ Mucous membranes
○ Weight loss
Differential Diagnosis:
★ Consider other systems
○ Respiratory
○ Neurological
○ Musculoskeletal ■
○ Metabolic ■ Normal = moist, salmon pink
● Oral often paler than conjunctiva
Physical Examination ■ Capillary Refill time
● Estimates tissue perfusion
★ Observation ● Blanch mucous membrane → Measure
○ Demeanor time taken for normal pink color to
appear
○ Normal CRT = <3 sec
