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You are currently examining Reggie
Reggie has a grade 3 mitral valve murmur; how would you like to proceed?
Correct
X-rays are a good choice here to determine whether Reggie has cardiomegaly as a result of his 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.
Sedating a canine cardiac patient for diagnostic imaging
Kieran Borgeat
- American, European and RCVS Specialist in Veterinary Cardiology
- Langford Vets, University of Bristol
Reggie 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.
Assessing heart size using ultrasound – the LA:Ao
Nuala Summerfield
- Founder and Director, Virtual Veterinary Specialists
- RCVS Specialist in Veterinary Cardiology
- DipACVIM DipECVIM-CA (Cardiology)
Reggie 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
Using X-ray or ultrasound to diagnose cardiomegaly in asymptomatic MVD
Nuala Summerfield
- Founder and Director, Virtual Veterinary Specialists
- RCVS Specialist in Veterinary Cardiology
- DipACVIM DipECVIM-CA (Cardiology)
Reggie has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Reggie.
An ECG is a useful diagnostic procedure when a cardiac arrhythmia is evident during clinical examination. Since Reggie did not have an arrhythmia on clinical exam, an ECG is not a priority.2
Reggie has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Reggie.
24-hour ambulatory ECGs (Holter) are useful for the evaluation of cardiac arrhythmias. Since no arrhythmias were detected in Reggie, other investigations should take priority.2
Reggie has a grade 3 mitral valve murmur; how would you like to proceed?
Incorrect
This may not be the best choice for Reggie.
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 Reggie for cardiomegaly means he may be missing out on the opportunity of a longer, happier life.4