Diagnostic Imaging of the Heart
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What does radiography of the heart a) show b) not show?
- a) overall size, shape, location, evidence of congestive heart failure e.g. pulmonary oedema
- b) Internal structures of the heart, myocardial function, valve incompetence
What does ultrasound (echocardiography) of the heart show?
chamber size, myocardial function, blood flow and leakage through valves, disease of internal cardiac structures
How large should a normal a) dog b) cat heart be on a lateral radiograph?
- a) 3-3.5 intercostal spaces
- b) 2-3 intercostal spaces
Where should a normal heart be positioned within the thorax?
Between ribs 3-6
Using the clock face analogy, what structures are located at the following times on a right lateral radiograph? a) 12-3 b) 3-5 c) 8-10 d) 10-12?
- a) left atrium
- b) left ventricle
- c) right ventricle
- d) great vessels (aorta and pulmonary trunk)
Using the clock face analogy, what structures are located at the following times on a dorsoventral radiograph? a) 11-1 b) 1-2 c) 2-3 d) 3-5 e) 5-9 f) 9-11?
- a) aortic arch
- b) pulmonary artery
- c) left auricular appendage
- d) left ventricle
- e) right ventricle
- f) right atrium
How do you measure the vertebral heart score?
X + Y = VHS (where Y = measure the number of vertebral bodies from base to apex of heart, and X = measurement at right angle to Y)
What are the different types of echocardiography?
B-mode, M-mode and Doppler
What does B-mode show?
A single slice of anatomy
What does M-mode show?
Shows movement or contraction of structures over time
What would you use M-mode for when imaging the heart?
Measurement of myocardial contractility so allows assessment of myocardial function
What does Doppler imaging of the heart allow you to look at?
Allows measurement of blood flow
With regards to doppler imaging what does BART stand for?
Blue Away, Red Towards (colour of blood flow away or towards the transducer)
What shape should the left ventricle appear like during echocardiography?
Mushroom shaped, due to the papillary muscles
What shape does the mitral valve look like on echocardiography?
Like a fish mouth
The diameter of the left atrium should not exceed .... the diameter of the aorta?
How many cusps does the aortic semilunar valve have?
What colour should blood flow from the atrium to ventricles be on doppler imaging?
Red (towards the transducer)
What colour should blood flow from the ventricle to the aorta be on doppler imaging?
Blue/green (away from the transducer)
What are the following types of common cardiac disease? a) Dilated cardiomyopathy b) hypertrophic cardiomyopathy c) valvular disease d) pericardial disease?
- a) Reduced myocardial contractility which leads to decreased CO and dilation of the chambers
- b) Decreased capacity of the ventricles which leads to decreased CO
- c) Dysplasia, infection, etc. Also leakage of valves and chamber dilation.
- d) Fluid in the pericardial sac which prevents proper filling of heart chambers and reduces CO
In cats with hypertrophic cardiomyopathy what change can be seen on a dorsoventral radiograph?
A 'valentines heart' - the heart becomes more triangular
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