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Cardiac disease is '''not a common finding''' in captive reptiles.  
 
Cardiac disease is '''not a common finding''' in captive reptiles.  
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When cases are presented, it is important to characterise whether the cardiac disease is the primary cause of the illness or the
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When cases are presented, it is important to characterise whether the cardiac disease is the primary cause of the illness or the secondary result of other systemic illness. It seems that the majority of the cases presented are secondary to systemic illness.
secondary result of other systemic illness. It seems that the majority of the cases presented are secondary to systemic illness.
      
'''Primary disease''' may involve '''right AV valve insufficiency''', which has been reported in one carpet python, resulting in congestive heart failure.   
 
'''Primary disease''' may involve '''right AV valve insufficiency''', which has been reported in one carpet python, resulting in congestive heart failure.   
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Due to the lack of septation in squamata and chelonia, elevated diastolic pressures could be shared across all ventricular compartments, resulting in bilateral heart failure.  
 
Due to the lack of septation in squamata and chelonia, elevated diastolic pressures could be shared across all ventricular compartments, resulting in bilateral heart failure.  
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'''Murmurs''' can occasionally be ausculted. '''Tachycardia''' has been observed with cardiac insufficiency, and cardiomegaly may be evident on physical examination.  
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'''Murmurs''' can occasionally be auscultated. '''Tachycardia''' has been observed with cardiac insufficiency, and cardiomegaly may be evident on physical examination.  
    
'''Dilated cardiomyopathy''' has been anecdotally reported in snakes as spontaneous disease as well as following infection.
 
'''Dilated cardiomyopathy''' has been anecdotally reported in snakes as spontaneous disease as well as following infection.
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'''Aortic aneurism''' has been reported in a Burmese python; '''pericardial effusion''' of unknown etiology in a turtle; '''myocardial ''Listeriosis''''' in a bearded dragon; '''myocardial ''salmonellosis''''' in a boa; cardiovascular spirorchid flukes can cause endocarditis, arteritis and thrombosis in green turtles.  
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'''Aortic aneurism''' has been reported in a Burmese python; '''pericardial effusion''' of unknown etiology in a turtle; '''myocardial listeriosis''' in a bearded dragon; '''myocardial salmonellosis''' in a boa; cardiovascular spirorchid flukes can cause endocarditis, arteritis and thrombosis in green turtles.  
    
The heart of most snakes is located at a point '''one-third to one-fourth of its length''' caudal to the head. In some aquatic species, the heart is located in a more cranial position. The chelonian heart is located on the ventral midline where the humeral, pectoral, and abdominal scutes of the plastron intersect. In most species of lizards, the heart is encased in the pectoral girdle. Varanidsare an exception, as their heart is located more caudally in the coelomic cavity.
 
The heart of most snakes is located at a point '''one-third to one-fourth of its length''' caudal to the head. In some aquatic species, the heart is located in a more cranial position. The chelonian heart is located on the ventral midline where the humeral, pectoral, and abdominal scutes of the plastron intersect. In most species of lizards, the heart is encased in the pectoral girdle. Varanidsare an exception, as their heart is located more caudally in the coelomic cavity.
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==Diagnosis==
 
==Diagnosis==
As well as the physical examination, '''haematology and plasma biochemistry''' are important diagnostic tests that provide insight into the working physiology of the patient. Elevations in '''creatine kinase''' activity appear to be highly correlated to
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As well as the physical examination, '''haematology and plasma biochemistry''' are important diagnostic tests that provide insight into the working physiology of the patient. Elevations in '''creatine kinase''' activity appear to be highly correlated to cardiac muscle in the [[Green Iguana|green iguana]]. Alterations in '''aspartate aminotransferase''' may also occur with damage or injury to the cardiac muscle. Imbalances noted with electrolytes, enzymes, proteins, and minerals should be addressed when developing a treatment plan.
cardiac muscle in the green iguana. Alterations in '''aspartate aminotransferase''' may also occur with damage or injury to the cardiac muscle. Imbalances noted with electrolytes, enzymes, proteins, and minerals should be addressed when developing a treatment plan.
      
The '''ECG''' can be an invaluable tool for monitoring cardiac function in reptiles. Interpretation of the ECG may be difficult but may highlight some electrical conduction disturbances.
 
The '''ECG''' can be an invaluable tool for monitoring cardiac function in reptiles. Interpretation of the ECG may be difficult but may highlight some electrical conduction disturbances.
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Various diuretics have been used but the lack of appropriate receptors in the kidney is a potential problem.
 
Various diuretics have been used but the lack of appropriate receptors in the kidney is a potential problem.
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==Lizards==
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[[Image:Cardiovascular_lizard.jpg|400px|thumb|right|(Copyright © RVC)]]
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Cardiovascular disease may be primary or secondary.
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'''Aetiology''' - it may be infectious, parasitic, congenital or nutritional (e.g. calcification of large vessels)
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'''Clinical signs''' - Clinical signs of cardiovascular disease are usually non-specific such as anorexia and weight loss. Signs such as swelling in the area of the heart, peripheral oedema and ascites warrant investigation of the cardiovascular system.
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'''Diagnosis'''
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*History
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*[[Lizard Physical Examination|Physical examination]], especially auscultation
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*Blood culture
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*Radiography
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*Ultrasound
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*Doppler flow detector
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*Electrocardiography though interpretation may be a problem
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*[[Lizard Necropsy|Necropsy]]
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'''Treatment''' - Includes supportive treatment, antimicrobial if infectious, and correction of [[Lizard Husbandry Requirements|husbandry]].
    
{{Learning
 
{{Learning
 
|flashcards = [[Reptiles and Amphibians Q&A 22]]
 
|flashcards = [[Reptiles and Amphibians Q&A 22]]
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|literature search = [http://www.cabdirect.org/search.html?q=(((title:(heart)+OR+ab:(heart))+AND+(title:(lizard)+OR+ab:(lizard)+OR+od:(lizards))+AND+sc:%22ve%22))+OR+(((title:(lizard)+OR+ab:(lizard)+OR+od:(lizards))+AND+(subject:(cardiovascular+diseases)+OR+subject:(cardiovascular+system+diseases)+OR+subject:(cardiology)+OR+subject:(cardiovascular+disorders)+OR+subject:(heart+diseases)+OR+subject:(vascular+diseases)+OR+subject:(circulatory+disorders)+OR+subject:(circulatory+diseases))+AND+sc:%22ve%22)) Lizard Cardiovascular Disease publications]
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|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2007/20073287994.pdf '''Approach to the exotic cardiology patient.''' Rishniw, M.; Australian Small Animal Veterinary Association, Bondi, Australia, 32nd World Small Animal Veterinary Association Congress, Sydney Convention Centre, Darling Harbour, Australia, 19-23 August 2007, 2007, pp unpaginated, 31 ref. - '''Full Text Article''']
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[http://www.cabi.org/cabdirect/FullTextPDF/2007/20073287993.pdf ''' Reptile cardiology.''' Rishniw, M.; Australian Small Animal Veterinary Association, Bondi, Australia, 32nd World Small Animal Veterinary Association Congress, Sydney Convention Centre, Darling Harbour, Australia, 19-23 August 2007, 2007, pp unpaginated, 39 ref. - '''Full Text Article''']
 
}}
 
}}
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Kik, M. (2005) '''Reptile Cardiology: A Review of Anatomy and Physiology, Diagnostic Approaches, and Clinical Disease''' ''Seminars in Avian and Exotic Pet Medicine, Vol 14, No 1: pp 52– 60''
 
Kik, M. (2005) '''Reptile Cardiology: A Review of Anatomy and Physiology, Diagnostic Approaches, and Clinical Disease''' ''Seminars in Avian and Exotic Pet Medicine, Vol 14, No 1: pp 52– 60''
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[[Category:To Do - Helen]]
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[[Category:To Do - Review]]
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{{review}}
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[[Category:Snake Diseases]]
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[[Category:Expert Review - Exotics]]
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