The
Heart
Diagnostic
Tools
Chest
X-rays
show the size of the cardiac silhouette which may or may not be
the same size as the heart itself. (Certain conditions that cause
a build up of fluid around the heart could make the heart appear
larger than it actually is.) Usually the silhouette is equal to
the size of the heart so that chest X-rays give us an impression
of heart size. We can also see the diameter of the trachea (windpiipe)
and the bronchi, the blood vessels in the lungs, whether the lungs
are clear or have some sort of infiltrate (fluid, pus, blood,
etc.) and whether the infiltrate appears to be in the alveoli
(air sacs) of the lungs or in the spaces between. We can sometimes
see evidence of a mass (like a tumor) in the lungs or on the heart.
For evaluating heart disease, these are not very accurate since
enlargement of the heart usually comes later in heart disease
after symptoms have begun.
ECG
(EKG)
is a measurement of the electrical activity of the heart. When
leads from the ECG machine are attached to different areas of
the animal the electrical impulses are measured across those leads
(one is a positive electrode and one negative). When an electrical
impulse from the heart moves toward the positive lead, there is
a positive (upward) blip made on the ECG screen or paper, while
an impulse moving away from the positive lead produces the negative
blip. The ECG can be valuable in diagnosing arrythmias if they
are occurring continuously or with very high frequency (several
per minute). If the arrythmias are sporadic, they are of use only
if the arrythmia is occurring at the time of the exam. It is true
that significant cardiac disease may be present and produce minor
or NO abnormalities on ECG. The ECG does not show how the heart
is functioning mechanically, only how the electrical impulses
are occurring.
Echocardiograms
are made by use of Ultrasound equipment. The echo does allow one
to see the mechanical function of the heart. You can see the heart
contracting, the valves opening and closing and how they move,
whether there are any irregularities (vegetative growths) on the
valves. You can measure the chamber diameters when the heart is
contracting and when it is relaxed. You can measure the thickness
of the muscular walls of the chambers. Doppler echocardiography
adds a sound component to the above and allows one to hear the
turbulence that is known as a heart murmur in an amplified mode.
Color-flow
doppler
also adds color to the image and allows visualization of blood
flow through the heart and major vessels.
The
Holter Monitor
is a backpack type recording device that enables a prolonged sampling
of an ECG. This piece of equipment is the most useful in detecting
intermittant arrythmias due to the long sample time (24 hours
or longer). Since most cases of boxer cardiomyopathy begin in
the early phase as a minor arrythmia, this is the most useful
piece of equipment we have available currently to "screen" boxers
for arrythmias.
Event
recorder.
This is a device that can be worn for prolonged periods of time
and activated only if the patient has an episode. It is a continuous
loop type recorder, so that when activated by the push of a button,
it saves the ECG pattern for the last several minutes. This would
be useful for a dog that is having fainting spells (syncope) but
who has normal ECGs when examined at the veterinary office. The
owner would be instructed to push the activation button when the
animal had the next episode. One could then determine if the cause
of fainting was of cardiac origin (like an arrythmia).