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You are currently examining Poppy

Let’s perform a thoracic X-ray to assess the size of Poppy’s heart

using the vertebral heart score (VHS), to determine whether she has cardiomegaly as a result of her MVD

Select the carina and then the cardiac apex

Measure the long axis of the heart from the ventral border of the carina (ventral border of the tracheal bifurcation) to the most distant ventral contour of the cardiac apex.

Try again. Tap the carina and then the cardiac apex

Now, select the cardiac apex

Select either side of the widest part of the heart

Measure the short axis of the heart.

Try again, select either side of the widest part of the heart

Select the cranial edge of the fourth thoracic vertebra (T4)

Locate the fourth thoracic vertebra (T4).

Count the number of individual vertebral bodies transversed by each of the measurements, estimated to the nearest tenth of a whole number and add these values together

Long axis measurement = 6.7

Short axis measurement = 5.6

Turn hints

The cardiac apex is located at the tip of the left ventricle.

The carina is located at the ventral border of the tracheal bifurcation.

Measure the widest part of the heart. This should be in the central third region of the heart, extending from the cranial to the caudal border of the cardiac silhouette, perpendicular to the long axis.

The T4 vertebra is the fourth thoracic vertebra along the spine. The fourth thoracic vertebra can be found by counting caudally from the first thoracic vertebra which has a long spinous process.

6.7 + 5.6 VHS = 12.3
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6.7
5.6

Poppy has a vertebral heart score (VHS) of 12.3

Cardiomegaly is present.

VHS PARAMETERS*
≥11.5 Cardiomegaly
10.5 to < 11.5 Borderline cardiomegaly. An ultrasound should be performed for an assessment of left atrial size or the VHS rechecked in 6 months.
<10.5 No cardiomegaly present at this time

*Breed variation exists. A breed-specific VHS table is available on the Boehringer Academy

How to measure the VHS

Nuala Summerfield
  • Founder and Director, Virtual Veterinary Specialists
  • RCVS Specialist in Veterinary Cardiology
  • DipACVIM DipECVIM-CA (Cardiology)