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Heart Failure, Diagnosis (view source)
Revision as of 13:18, 5 September 2008
, 13:18, 5 September 2008New page: {{toplink |backcolour = |linkpage =Cardiology - WikiClinical |linktext =Cardiology |sublink1=Cardiovascular Conditions - WikiClinical |subtext1=CARDIOVASCULAR CONDITIONS |maplink1= Cardiov...
{{toplink
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
==History & Clinical Signs==
-Cough
-Dyspnea
-Tachypnea
-Orthopnea
-Exercise Intolerance
-Syncope
-Lethargy
-Ascites
-Peripheral Edema
-Weight Loss
-Capillary Refill Time: under 3 seconds is normal; over 3 seconds is abnormal
-Mucous Membrane Color:
Pallor=pale skin/mucus membrane; suggests poor peripheral circulation due to vasoconstriction, decreased hemoglobin in the blood (anemia), or shock
Cyanosis=blue skin/mucus membrane discoloration; Suggests adequate hemoglobin, but inadequate oxygenation; Seen with Pleural effusion/pulmonary edema, right to left shunt within the circulation causing deoxygenated blood to mix with oxygenated blood
*Signs of heart failure are directly related to which side is affected.
*The above signs are characteristic of cardiac problems, but can also be the signs of other diseases involving different body systems.
*A good physical exam including signalment, history, observation, palpation, percussion, and auscultation are necessary to identify true cardiac problems.
===Physical Exam===
====1. Observation====
-Clinical signs: (listed above)
====2. Palpation====
-Precordium:(Left side of the chest behind the elbow where heart contractions are easily palpated and auscultated)
Heart Rate, Rhythm, Character
Apex Beat
Palpable Thrill
-Pulse: (Rate, Rhythm, Character)
Dog: Femoral Pulse; Palpate heart
Horse: External Maxillary/Facial Artery; Transverse Facial Artery; Median Artery; Digital Artery; Metatarsal Artery
Cattle: External Maxillary/Facial Artery; Middle Coccygeal Artery; Median Artery
Pulse Deficits (Seen with Arrhythmias)
Jugular Pulses and/or Jugular Venous Distension and/or Enlarged Ventral Abdominal Veins (Indicates High Venous Pressure)
-Abdomen:
Pitting Edema
Ascites
Splenomegaly
Hepatomegaly
Fluid Thrill (Fluid movement causes a palpable vibration)
====3. Percussion====
A method of diagnosis performed by flicking a body part with fingers and the resulting sound helps determine size, position, and density of the underlying structures.
-Thorax: Lack of resonance if the lung has solidified; Detection of fluid line
-Abdomen: Detection of fluid thrill
====4. Auscultation====
A method of diagnosis performed by listening to sounds inside the body. Auscultation can be performed with or without a stethoscope. Abdominal, cardiac, pulmonary, and thoracic auscultation can all be performed.
Cardiac auscultation is used to listen to heart sounds & heart murmurs.
'''Heart Sounds'''
Cardiac Auscultation Species Differences:
'''Dog & Cat'''
Normal Heart Sounds: S1 (closure of atrioventricular valves; heard best at left heart apex) & S2(closure of semilunar valves; heard best at left heart base); Lub-Dup sound
Abnormal Heart Sounds: S3 & S4 occur during diastole and should not be audible in dogs and cats. If either one is present, this is called a GALLOP RHYTHM and suggests poor ventricular filling. Du-Lub-Dup sound.
'''Horse'''
Normal Heart Sounds: S1 & S2, S3 & S4; S3 is audible in many horses and marks the end of ventricular filling.
'''Ox'''
Normal Heart Sounds: S1 & S2, S4; Healthy farm animals do not have an audible S3 as in the horse.
'''Heart Murmurs'''
-Heart Murmurs=abnormal heart sounds due to turbulent blood flow. Heart murmurs are characterized based on their timing, location, intensity, radiation, pitch, and shape.
===Electrocardiography (ECG)===
-Not needed in the diagnosis of heart failure
-Can be used to recognize arrhythmias or conduction problems
===Radiology===
-Cardiac enlargement +/-
'''Right-Sided Heart Failure:'''
-Ascites
-Hepatomegaly
-Pleural Effusion
'''Left-Sided Heart Failure:'''
-Pulmonary edema
-Pulmonary venous distension
===Echocardiography===
-Used to determine the cause of heart failure
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
==History & Clinical Signs==
-Cough
-Dyspnea
-Tachypnea
-Orthopnea
-Exercise Intolerance
-Syncope
-Lethargy
-Ascites
-Peripheral Edema
-Weight Loss
-Capillary Refill Time: under 3 seconds is normal; over 3 seconds is abnormal
-Mucous Membrane Color:
Pallor=pale skin/mucus membrane; suggests poor peripheral circulation due to vasoconstriction, decreased hemoglobin in the blood (anemia), or shock
Cyanosis=blue skin/mucus membrane discoloration; Suggests adequate hemoglobin, but inadequate oxygenation; Seen with Pleural effusion/pulmonary edema, right to left shunt within the circulation causing deoxygenated blood to mix with oxygenated blood
*Signs of heart failure are directly related to which side is affected.
*The above signs are characteristic of cardiac problems, but can also be the signs of other diseases involving different body systems.
*A good physical exam including signalment, history, observation, palpation, percussion, and auscultation are necessary to identify true cardiac problems.
===Physical Exam===
====1. Observation====
-Clinical signs: (listed above)
====2. Palpation====
-Precordium:(Left side of the chest behind the elbow where heart contractions are easily palpated and auscultated)
Heart Rate, Rhythm, Character
Apex Beat
Palpable Thrill
-Pulse: (Rate, Rhythm, Character)
Dog: Femoral Pulse; Palpate heart
Horse: External Maxillary/Facial Artery; Transverse Facial Artery; Median Artery; Digital Artery; Metatarsal Artery
Cattle: External Maxillary/Facial Artery; Middle Coccygeal Artery; Median Artery
Pulse Deficits (Seen with Arrhythmias)
Jugular Pulses and/or Jugular Venous Distension and/or Enlarged Ventral Abdominal Veins (Indicates High Venous Pressure)
-Abdomen:
Pitting Edema
Ascites
Splenomegaly
Hepatomegaly
Fluid Thrill (Fluid movement causes a palpable vibration)
====3. Percussion====
A method of diagnosis performed by flicking a body part with fingers and the resulting sound helps determine size, position, and density of the underlying structures.
-Thorax: Lack of resonance if the lung has solidified; Detection of fluid line
-Abdomen: Detection of fluid thrill
====4. Auscultation====
A method of diagnosis performed by listening to sounds inside the body. Auscultation can be performed with or without a stethoscope. Abdominal, cardiac, pulmonary, and thoracic auscultation can all be performed.
Cardiac auscultation is used to listen to heart sounds & heart murmurs.
'''Heart Sounds'''
Cardiac Auscultation Species Differences:
'''Dog & Cat'''
Normal Heart Sounds: S1 (closure of atrioventricular valves; heard best at left heart apex) & S2(closure of semilunar valves; heard best at left heart base); Lub-Dup sound
Abnormal Heart Sounds: S3 & S4 occur during diastole and should not be audible in dogs and cats. If either one is present, this is called a GALLOP RHYTHM and suggests poor ventricular filling. Du-Lub-Dup sound.
'''Horse'''
Normal Heart Sounds: S1 & S2, S3 & S4; S3 is audible in many horses and marks the end of ventricular filling.
'''Ox'''
Normal Heart Sounds: S1 & S2, S4; Healthy farm animals do not have an audible S3 as in the horse.
'''Heart Murmurs'''
-Heart Murmurs=abnormal heart sounds due to turbulent blood flow. Heart murmurs are characterized based on their timing, location, intensity, radiation, pitch, and shape.
===Electrocardiography (ECG)===
-Not needed in the diagnosis of heart failure
-Can be used to recognize arrhythmias or conduction problems
===Radiology===
-Cardiac enlargement +/-
'''Right-Sided Heart Failure:'''
-Ascites
-Hepatomegaly
-Pleural Effusion
'''Left-Sided Heart Failure:'''
-Pulmonary edema
-Pulmonary venous distension
===Echocardiography===
-Used to determine the cause of heart failure