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Indications for a Cardiology Consult
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Patients with cardiac disease require specialized diagnostics for a definitive diagnosis. A definitive diagnosis is the only way to determine a proper therapeutic plan and prognosis. The finding of evidence of cardiac disease is the first step in working through the process to provide patients with optimum care. The second step is an attempt to obtain a definitive diagnosis. For example, there are many causes for heart murmurs. The presence of a heart murmur usually indicates the presence of cardiac disease; it is not a diagnosis. The need for cardiac medications is a guessing game without a definitive diagnosis. Echocardiography is the most effective non-invasive method of determining a definitive diagnosis for the cause of the cardiac murmur and the need for cardiac medications. Additionally, echocardiography can be an important part of providing a prognosis for the patient. Furthermore, echocardiography is the state-of-the-art diagnostic tool for the non-invasive diagnosis of myocardial dysfunction such as that seen with canine dilated cardiomyopathy, chronic valvular or congenital heart disease, or the various feline cardiomyopathies.
There are many clinical clinical scenarios in which a cardiology consultation is indicated. Consider the following:
- 1. Abnormal cardiac auscultation revealing the presence of a cardiac murmur, a gallop rhythm, systolic clicks, muffled heart sounds, abnormal adventitial sounds, or cardiac dysrhythmias.
- 2. Jugular distention/pulses suggesting the presence of right heart disease, heart failure, or pulmonary hypertension.
- 3. Peripheral edema in patients with normal serum protein levels.
- 4. Abdominal distention secondary to the presence of effusions.
- 5. Coughing, abnormal respiration rate at rest and open- mouth breathing at rest or after brief exercise.
- 6. Fainting or other signs of reduced cardiac output.
- 7. Exercise intolerance.
- 8. Abnormal cardiac rhythms as demonstrated by electrocardiography (ECG) such as tachycardias and bradycardias.
- 9. Cardiomegaly as demonstrated by thoracic radiography.
- 10. Breeding certifications for breeds that are predisposed for cardiac disease such as cardiomyopathy (Boxer dogs, Doberman pinschers, Great Danes, etc.), early valvular disease (Cavalier King Charles Spaniels), or suspected congenital heart disease (any breed with a murmur early in life).
Proper evaluation of the above clinical scenarios requires expertise in all echocardiographic modalities (2-Dimensional, M-mode, and Doppler). Veterinarians with board-certification in cardiology are the only veterinarians that receive extensive and detailed training in echocardiography. This training cannot be compared to short echocardiography training courses. Veterinary Cardiac Consultations, LLC provides this kind of expertise that has the additional benefit of over 15 years of clinical experience.
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