Lesson 14, Topic 3
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The diagnostic test of choice is echocardiography.

presumptive diagnosis can be made with:

  1. A large globose heart on radiography and
  2. The Triad of jugular venous distention, muffled heart sounds, and weak arterial pulse detected on physical examination.
  3. Radiology:
  • A very large globose heart (loss of chamber contour)
  • Pulmonary edema is very unusual
  • Pleural effusions are common. When present these can markedly obscure the silhouette of the heart thus “hiding” the radiographic appearance of a globose heart.
  • Pulmonary metastatic lesions may be present (HSA)
  • In the cat with hypertrophic cardiomyopathy we have seen both pleural effusion and pericardial effusion
  1. ECG may show:
  • Low amplitude QRS complexes
  • Electrical alternans
  • Usually normal (sinus rhythm)
  • Sinus tachycardia
  • Ventricular premature beats are common
  1. Blood Work may show:
  • CBC evidence of hemangiosarcoma may be present (nucleated rbc, regeneration, schistocytes, with a fairly normal PCV)
  1. Echocardiography:
  • Pericardial effusion is readily detected
  • A tumor present in the region of the right auricle, right atrium, or right ventricle in cases of hemangiosarcoma
  • A tumor at the base of the aorta (heart base tumor) may be noted
  • Cardiac tumors are easier to visualize while the effusion is still present
  1. Other tests:
  • Cytology of pericardial fluid.
    • This analysis has been shown to be of little value in distinguishing between idiopathic and neoplastic etiologies. However, the pericardial fluid analysis may reveal a septic etiology or the presence of chyle
  • Pneumopericardiography:
    • At the time of centesis, a volume of carbon dioxide equal to 1/2 to 3/4 the volume of fluid removed from the pericardial sac is injected into the sac followed by both lateral radiographic views and a D/V and V/D view. This procedure has been useful to identify the presence of heart base tumors. The availability of cardiac ultrasound makes pneumopericardiography much less useful.