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You are currently examining Poppy
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Correct
X-rays are a good choice here to determine whether Poppy has cardiomegaly as a result of her mitral valve disease.
They also allow for evaluation of the pulmonary parenchyma, airways and pulmonary vessels.2
However, X-rays are not as sensitive as ultrasound at picking up less advanced cardiomegaly and they cannot evaluate the individual chambers of the heart.
In addition, sedation and/or general anaesthesia may be required.
Advantages and disadvantages of using X-ray to diagnose cardiomegaly
Nuala Summerfield
- Founder and Director, Virtual Veterinary Specialists
- RCVS Specialist in Veterinary Cardiology
- DipACVIM DipECVIM-CA (Cardiology)
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Correct
Cardiac ultrasound is a good tool to diagnose whether cardiomegaly is present as a result of mitral valve disease, and can pick up heart size increases earlier than X-ray.
It also enables an in–depth analysis of individual cardiac chambers, heart muscle function and health of the heart valves.2
However, you may be more familiar interpreting X-rays than ultrasound images and X-rays are generally more readily available.
The importance of good patient restraint when performing a cardiac ultrasound
Kieran Borgeat
- American, European and RCVS Specialist in Veterinary Cardiology
- Langford Vets, University of Bristol
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Correct
Both X-ray and cardiac ultrasound can be used to determine whether a dog has cardiomegaly, as a result of their mitral valve disease. However, you don’t need to perform both to diagnose cardiomegaly.
There are advantages and disadvantages of each, and the test you choose is likely to come down to a number of factors, including:
- Availability of equipment
- Owner’s budget
- Owner’s preference
X-ray or ultrasound to diagnose cardiomegaly? Hear the advantages and disadvantages of each
Nuala Summerfield
- Founder and Director, Virtual Veterinary Specialists
- RCVS Specialist in Veterinary Cardiology
- DipACVIM DipECVIM-CA (Cardiology)
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Poppy.
An ECG is a useful diagnostic procedure when a cardiac arrhythmia is evident during clinical examination. Since Poppy did not have an arrhythmia on clinical exam, an ECG is not a priority.2
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Poppy.
24-hour ambulatory ECGs (Holter) are useful for the evaluation of cardiac arrhythmias. Since no arrhythmias were detected in Poppy, other investigations should take priority.2
Poppy has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Poppy.
About half of dogs with a grade 3/6 mitral valve disease murmur have cardiomegaly3 and would benefit from treatment with Vetmedin®4.
Choosing not to investigate Poppy for cardiomegaly means she may be missing out on the opportunity of a longer, happier life.4