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Cardiology

Topic- Atrioventricular Valvular Stenosis

Topic- Patent Ductus Arteriosus

Figure 1. M-mode image recorded at the mitral valve leve


l showsa thickened mitral valve with concordant motion o
f the anteriorand posterior mitral valve leaflets (arrow
). RV = right ventricle, LV = left ventricle, MV = mitr
al valve, IVS = interventricularseptum, LVPW = left vent
ricular posterior wall.
Figure 2. Spectral Doppler of mitral inflow in a dog with
mitral stenosis

Figure 1. Intraoperative photograph of a patent ductus a


rteriosus (PDA) in a cat. The very large ductus (arrow)
evident in this case extends from the descending aorta (
just below the red rubber tube) to the origin of the lef
t pulmonary artery (PA). Two ligatures have been passed
around the ductus.
Figure 2. Angiocardiogram showing contrast opacification
of the ascending aorta and aortic arch (Arch), ductus art
eriosus (DA) and entry of the ductus into the pulmonary a
rtery (arrow). Due to left-to-right shunting the pulmonar
y arterial system is partially illuminated with contrast.
Figure 3. Lateral radiograph obtained from a dog with a l
eft to right shunting PDA. The left ventricle is enlarged
leading to elongation of the heart (double arrow). The l
eft atrium (LA) is markedly dilated. There is pulmonary o
vercirculation especially evident in the caudodorsal lung
fields. The cranial pulmonary vein is distended (single
arrows).

shows prolonged pressure half-time (P1/2t) of 3


11ms (normal <50ms) and elevated mean pressure
gradient (mean PG) of 14mmHg (normal <5mmHg).
Figure 3. Spectral Doppler of mitral inflow in the same
dog as figure 4 when the dogs heart rate accelerated.
Note the increased mean pressure gradient (mean
PG) of 22mmHg at a heart rate of 191bpm versus 1
4mmHg in Figure 4 when the heart rate was 120bpm
.
Figure 4. Spectral Doppler of mitral inflow in a dog with m
itral stenosis, mitral regurgitation (MR) and atrial fibril
lation.

Note the prolonged pressure half-time during diastoli


c filling. A faint jet of mitral regurgitation (MR) i
s also evident. Due to the atrial fibrillation the Awave of mitral inflow is absent. Note the end-diastol
ic velocity is lower with long diastolic cycles indic
ative of the reduced pressure gradient associated wit
Blackwells
h a lower heart
rate. Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition

Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Figure 4.
Dorsoventral (left) and ventrodorsal (right) radiograph
s obtained from two dogs with PDA.
Left: a left to right shunting PDA with cardiac elongatio
n from left ventricular dilation, a prominent left auricu
lar bulge (right arrow), and dilation of the descending a
orta or ductus bump (at the edge of the two arrows). Ri
ght: a right to left shunting PDA with prominence of the
right ventricle and dilation of the main pulmonary artery
(top arrow) and lobar arteries (the left caudal branch i
sFigure
shown
the two arrows).from a dog with PDA. Left cr
5.by
Echocardiogram
anial transducer position. The ductal ampulla (PDA) is
evident in both images showing the connection to the
pulmonary artery (PA). The color Doppler image shows t
urbulent flow from the PDA tracking along the edge of
the PA (arrowheads). Ao=aorta; RV=right ventricle.
Figure 6. Continuous wave Doppler image from the pulmon
ary artery recorded in a dog with left to right shunti
ng PDA. High velocity, continuous flow is evident enter
ing the PA from the ductus.

Figure 7. Echocardiographic images obtained from two c


ases of right to left shunting PDA.
Left: 2D image obtained from a cat shows a dilated duct
us (arrow) entering the origin of the left pulmonary ar
tery. The main pulmonary artery (PA), right (rPA) and l
eft (LPA) are dilated due to pulmonary hypertension.
Right: Spectral Doppler image obtained from a dog showing
low velocity bidirectional flow typical of reversed PD
A. There is left to right shunting in systole and right t
o left shunting in diastole.
Figure 8.
Amplatz designed ductal occluder within a ductus arterio
sus. The silhouette of the device is evident with a flat
disc on the pulmonary arterial side of the duct (arrow)
and a cup-like disc within the distal ductal ampulla. T
he two discs are more evident within the magnified image
(inset). The development of this device specifically fo
r dogs has provided an effective, minimally-invasive sol
ution for ductal closure.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic- Aortic Stenosis

Topic-Ascites

Figure 1. Angiogram of aortic stenosis.

Figure 1. Ascites in a doglateral radiography.

Figure 2. Postmortem of a dog with subaortic stenosis


demonstrating left ventricular (LV) hypertrophy, aortic
post-stenotic dilation (Ao), and a subvalvular fibrous
ridge (instrument pointer).

Figure 2. A dog with ascites.

Figure 3. Two-dimensional echocardiograph, right


parasternal long axis view, demonstrating a subvalvular r
idge typical of subaortic stenosis. Thickening of the ant
erior mitral valve leaflet (MV) is also apparent. Aorta
(Ao), left ventricle (LV), and left atrium (LA).
Figure 4. Similar to 1A with color flow Doppler overlay
demonstrating turbulent flow distal to the obstruction.
Topic-Aortic Thromboembolism
Figure 1.
Figure 2. A cat with thrombus of the left forelimb.

Topic-Atrial Fibrillation and Atrial Flutter


Figure 1. Atrial flutter with 2:1 conduction at ventricular
rate of 330/minute in a dog with an atrial septal defect.
This supraventricular tachycardia was associated with
a Wolff-Parkinson-White pattern. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography,
3rd ed. Baltimore: Williams & Wilkins, 1992, with
permission.)
Figure 2. Coarse atrial fibrillation in a dog with
patent ductus arteriosus. The f waves are prominent.
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography, 3rd ed. Baltimore: Williams &
Wilkins, 1992, with permission.)

Figure 3. A cat with thrombus and cyanotic pads.


Figure 4. Postmortem thrombus in a cat.
Figure 5. Aortic thromboembolism.
Figure 6. Aortic thromboembolism.
Figure 7. Aortic thromboembolism.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic- Atrial Premature Complexes

Topic-Atrial Standstill

Figure 1. APC in a dog. P9 represents the premature


complex. The premature QRS resembles the basic
QRS. The upright P9 wave is superimposed on the T
wave of the preceding complex. APC. (From: Tilley,
L.P. Essentials of canine and feline. 3rd ed. Blackwell
Publishing, 1992, with permission.)

Figure 1. Persistent atrial standstill in English springer


spaniel. No P waves are present on any of the
leads (also including chest leads and intracardiac
electrocardiogram, not shown here). The regular
bradycardia is either junctional in origin, with patholo
gic involvement of the left bundle branch block (wide po
sitive QRS complexes), or ventricular. (From: Tilley, L.
P. Essentials of canine and feline electrocardiography.
3rd ed. Baltimore: Williams & Wilkins, 1992, with permi
ssion.)
Topic-Atrial Wall Tear

Figure 2. APCs in bigeminy in a cat under general


anesthesia. The second complex of each pair is
an APC, where the first is a sinus complex. The
abnormality in rhythm disappeared after the anesthetic
was stopped. (From: Tilley, L.P. Essentials of canine an
d feline electrocardiography. 3rd ed. Blackwell Publishi
ng, 1992, with permission.)
Topic-Atrial Septal Defect
Figure 1. Atrial septal defect. Defect involves the
lowermost part of the atrial septum, known as ostium
primum defect. Note the left dominant left-to-right
shunt. RV = right ventricle, LV = left ventricle, RA =
right atrium, Ao = aorta, PT = pulmonary trunk. (From
Roberts W. Adult congenital heart disease. Philadelphi
a: FA Davis Co., 1987, with permission.)

Figure 1. Gross specimenleft atrial tear


Figure 2. Right parasternal short axis echocardiographic
image at the level of the aorta and left atrium. The ar
row points to an intra-atrial thrombus attached to the a
trial wall at the junction of the body of the left atriu
m and the left auricular appendage. Severe left atrial e
nlargement and pericardial effusion are present. LAA= Le
ft auricular appendage; LA=Left atrium; PE=Pericardial e
ffusion.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Figure 3. Right parasternal short axis echocardiographi
c
image at the level of the left ventricle (LV). Pericardial
effusion is noted and a characteristic linear thrombus is
seen within the pericardial sac adjacent to the LV. LV=
left ventricle; PE=pericardial effusion.

Figure 2. Complete heart block in a cat. The P waves


rate is 240/minute, independent of the ventricular
rate of 48/minute. QRS configuration is a left bundle
branch block pattern. (From: Tilley, L.P. Essentials of
canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)

Figure 4. Gross cardiac specimen from a dog with


advanced mitral endocardiosis that died following an
acute left atrial tear. The probe is pointing to a 2 cm
tear in the left atrial wall at the junction of the body of
the left atrium and left auricular appendage. LAA=left
auricular appendage; LA=left atrium. Photo courtesy of
Dr. Richard Jakowski.

Figure 3. Lateral radiograph of a dog with transvenous


pacemaker.

Topic-Atrioventricular Block, Complete (Third


Degree)
Figure 1. Complete heart block. The P waves occur at
a rate of 120, independent of the ventricular rate of 50.
The QRS configuration is a right bundle branch block
pattern. The regular rate and stable QRS indicate that
the rescuing focus is probably near the AV junction.
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992,
with permission.)

Topic-Atrioventricular Block, First Degree


Figure 1. Lead II ECG rhythm strip recorded from
a cat with hypertrophic cardiomyopathy. There is
sinus bradycardia (120 beats/minute) and first degree
atrioventricular conduction block. The PR interval is
0.12 second. (paper speed = 50 mm/s)
Figure 2. Lead II ECG rhythm strip recorded from a dog
showing sinus tachycardia (175 beats/minute) and first
degree atrioventricular conduction block. Because the
heart rate is rapid, P waves are superimposed on the
downslope of the preceding T waves. The PR interval
exceeds 0.16 second. (paper speed = 50 mm/s)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic-Atrioventricular Block, Second Degree Mobitz Type I
Figure 1. Lead II ECG strip recorded from a dog
with Mobitz type I, second degree AV block. The PR
intervals become progressively longer with the longest
PR intervals preceding nonconducted P waves (typical
Wenkebach phenomenon). (paper speed = 50 mm/s)
Topic-Atrioventricular Block, Second Degree Mobitz Type II
Figure 1. Lead II ECG rhythm strip recorded from a dog
with both first- and second-degree atrioventricular block.
The second-degree AV block is high grade with both 2:1
and 3:1 block resulting in variation in the RR intervals.
The PR interval for the conducted beats is prolonged
but constant (0.28 second) (paper speed = 25 mm/s).

Topic-Atrioventricular Valvular Stenosis


Figure 1. This image of the liver in a dog with tricuspid
stenosis and right heart failure shows markedly
distended hepatic veins.
Figure 2. This continuous wave Doppler recording
across the tricuspid valve in a dog with tricuspid
stenosis illustrates the prolonged pressure half time
(evidenced by the slope of the line between E and F
points) and the prominent atrial contribution (A) to filli
ng. This animal also had tricuspid regurgitation.
Topic-Cardiomyopathy, Dilated Cats
Figure 1. Postmortem of dilated cardiomyopathy (cat).
Figure 2. Echocardiogram of dilated cardiomyopathy
(cat).

Topic-Atrioventricular Valve Dysplasia

Topic-Cardiomyopathy, Dilated Dogs

Figure 1. Lateral radiographs of mitral valve dysplasia.


Topic-Atrioventricular Valve Endocardiosis

Figure 1. Gross postmortem of dilated cardiomyopathy


(dog).

Figure 1. Postmortem of valvular endocardiosis.

Figure 2. Electrocardiographic findings.

Figure 2. Lateral radiograph of mitral valve


endocardiosis.

Topic-Cardiomyopathy, Hypertrophic Cats


Figure 1. Dyspnea in a cat.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Figure 2. Chest radiograph (lateral) of hypertyrophic
cardiomyopathy (cat).

Figure 4. Abdominal venous distension in a dog with


right-sided heart failure.

Figure 3. Chest radiography (dorsoventral) of


hypertrophic cardiomyopathy (cat).

Topic-Digoxin Toxicity

Figure 4. Echocardiogram of hypertrophic


cardiomyopathy (cat).

Figure 1. Sagging type of S-T segment depression in a dog


with digitalis toxicity.
Topic-Endocarditis, Infective

Figure 5. Gross postmortem of hypertrophic


cardiomyopathy (cat).

Figure 1. Gross postmortem of bacterial endocarditis

Figure 6. Angiocardiogram of hypertrophic


cardiomyopathy (cat).

Figure 3. Echocardiogram of bacterial endocarditis.

Figure 2. Echocardiogram of bacterial endocarditis.

Topic-Cardiomyopathy, Restrictive Cats

Topic-Heartworm Disease Cats

Figure 1. Cardiomyopathy, restrictivecats.

Figure 1. Gross postmortem of heartworm disease in cat.

Topic-Congestive Heart Failure, Left-Sided

Topic-Heartworm Disease Dogs

Figure 1. Dyspnea in a cat.

Figure 1a. Microfilaria of dirofilaria and acanthocheilon


ema (Justin A. Thomason).
Figure 1b. Microfilaria of dirofilaria and
acanthocheilonema (Justin A. Thomason).

Figure 2. Cachexia in a dog.


Topic-Congestive Heart Failure, Right- Sided
Figure 1. Ascites in a doglateral radiography.
Figure 2. A dog with ascites.
Figure 3. Jugular distension in a cat with right-sided
congestive heart failure.

Figure 2. Dorsoventral radiograph of heartworm disease i


n a dog.
Figure 3. Echocardiogram of heartworm disease.
Figure 4. Gross postmortem of heartworm disease in a
dog.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic- Idioventricular Rhythm

Topic-Left Anterior Fascicular Block

Figure 1. Ventricular escape complexes (arrows) during


various phases in the dominant sinus rhythm in a dog du
ring anesthesia. The sinus rate increased (not shown)
after anesthesia was stopped; 1/2 cm1 mv. (From: Tilley
, L.P. Essentials of canine and feline electrocardiogr
aphy. 3rd ed. Blackwell Publishing, 1992, with permiss
ion.)
Figure 2. Complete heart block. The P waves occur at
a rate of 120, independent of the ventricular rate of 50.
The QRS configuration is a right bundle branch block
pattern. The regular rate and stable QRS indicate that
the rescuing focus is probably near the AV junction.
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)

Figure 1. Left anterior fascicular block in a cat with


hypertrophic cardiomyopathy. Severe left axis deviation
(2608) with a qR pattern in leads I and aVL and an rS
pattern in leads II, III, and aVF. The QRS complexes a
re of normal duration. (From: Tilley, L.P. Essentials o
f canine and feline electrocardiography. 3rd ed. Blackw
ell Publishing, 1992, with permission.)
Figure 2. Left anterior fascicular block in a dog with
hyperkalemia (serum potassium, 5.3 mEq/L). There is
abnormal left axis deviation (260_) with a qR pattern
in leads I and aVL and an rS pattern in leads II, III,
and aVF. The large T waves are compatible with
hyperkalemia. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic- Left Bundle Branch Block

Topic-Murmurs, Heart

Figure 1. Left bundle branch block in a cat with


hypertrophic cardiomyopathy. The QRS complex is
of 0.07-second duration and is positive in leads I, II,
III, aVF. Neither a Q wave nor an S wave occurs in
these leads. The QRS complex is inverted in leads
aVR. (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)
Figure 2. Intermittent left bundle branch block in a
Chihuahua. QRS complexes are wider (0.070.08
second) in the second, third, and fourth complexes an
d
in the last three complexes. Consistent P-R interval
confirms a sinus origin for the abnormal-appearing
QRS complexes (lead II, 50 mm/second, 1 cm 5 1
mV). (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)

Figure 1. Differential diagnosis of cardiac disease


based on the timing and location of murmurs. (Adapte
d
from Allen, D.G. Murmurs and abnormal heart sounds.
By permission of Mosby-Year Book, Inc. In: Allen,
D.G., Kruth, S.A., eds. Small animal cardiopulmonary
medicine. Philadelphia: BC Decker, 1988:13.)
Topic-Myocardial Infarction
Figure 1. Transmural infarction of the left ventricle in a
dog with arteriosclerosis and hypothyroidism. The first
three rapid successive complexes represent ventricular
tachycardia. The sinus rhythm that follows illustrates
small complexes, marked elevation of the S-T segment, a
nd first degree AV block (prolonged P-R interval). (Fro
m: Tilley, L.P. Essentials of canine and feline electro
cardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)
Topic-Patent Ductus Arteriosus
Figure 1. Angiocardiogram of patent ductus arteriosus.
Figure 2. Patent ductus arteriosus.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic-Pericarditis
Figure 1. The photograph demonstrates catheter
positioning and orientation for pericardiocentesis
from the right ventral approach. While stabilizing the
catheter near the entry point with one hand, the cathete
r is advanced in a cranial and dorsal direction with the
other, i.e. towards the opposite scapula. A small degre
e of suction is maintained with the syringe so that peri
cardial fluid is aspirated at the moment of pericardial
penetration. Subsequently the syringe and stylet are hel
d stationary while the flexible catheter is advanced wel
l into the pericardium. The sharp metal stylet is withdr
awn after
the catheter is fully
positioned.
Figure
2. Echocardiograph
acquired
with transducer
at the same location and orientation (direction) as the
catheter shown above. Dotted line indicates structures
encountered by the central ultrasound beam, i.e. in
the path of the catheter. While this patient had a
relatively small amount of pericardial effusion (PE),
proper catheter positioning, orientation, and linear
advancement minimizes risk. Oblique orientation of th
e
catheter, relative to the cardiac surface, increases the
effective distance between the pericardium and heart.

Figure 3. Instrumentation used for pericardiocentesis.


A 14g 5catheter and stylus are shown with a small
syringe attached, i.e. configured to advance into the
pericardial space. The sharp metal stylus is removed
after the catheter is fully positioned, as demonstrated
for the 16g 5catheter, and an extension tube attached
to the catheter for aspiration using a larger syringe an
d 3-way stopcock. An 18g 2 catheter is used for cats an
d similarly sized dogs. A #11 blade is ideal for creatin
g a small stab incision at the site of entry. The author
uses a #10 blade to cut side holes in the distal end of
the larger catheters
(optional).
Topic-Pleural
Effusion
Figure 1. Dyspnea in a cat.
Figure 2. Radiograph of pleural effusionlateral (dog).
Topic-Pulmonic Stenosis
Figure 1. Ventrodorsal radiograph of a dog with
pulmonic stenosis. There is a marked right ventricular
enlargement, with the apex shifted to the left. A
prominent pulmonary artery bulge is visible (arrow)
(Virginia Luis Fuentres).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Figure 2. Two-dimensional echocardiographic right
parasternal long axis view of a dog with severe
pulmonic stenosis. The right ventricular free wall and
interventricular septum are very hypertrophied, with mil
d right atrial enlargement (Virginia Luis Fuentres).
Figure 3. Continuous wave spectral Doppler recording
of pulmonary artery flow from a left cranial view in a
dog with severe pulmonic stenosis. Pulmonary artery
velocities are greatly increased (approximately 5 m/s).
Topic-Right Bundle Branch Block
Figure 1. Right bundle branch block in a dog. The
electrocardiographic features include QRS duration
of 0.08 second; positive QRS complex in aVR, aVL,
and CV5RL (M-shaped); and large wide S waves in
leads I, II, III, and aVF. There is a right axis deviation
(approximately 110) (50 mm/second, 1 cm 5 1
mV). (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)

Figure 2. Right bundle branch block in a cat with the


dilated form of cardiomyopathy. The QRS duration is
0.08 second (4 boxes). Large and wide S waves are
present in leads I, II, III, aVF, and CV6LU. The QRS
in CV5RL has a wide R wave (M-shaped). There
is a marked axis deviation (approximately 90 ).
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)
Topic-Sick Sinus Syndrome
Figure 1. A continuous lead II ECG rhythm strip
recorded from a dog with sick sinus syndrome. The
dogs rhythm is initially an ectopic atrial rhythm
(negative P waves; heart rate 187 beats/minute)
followed by asystole of more than 10 seconds duration
which is terminated by a junctional escape complex.
Four sinus complexes precede a brief sinus pause that
is again terminated by a junctional escape complex. T
he ectopic atrial rhythm then resumes. (paper speed =
50 mm/s)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic-Sinus Arrest and Sinoatrial Block

Topic-Sinus Bradycardia

Figure 1. Intermittent sinus arrest in a brachycephalic


breed with an upper respiratory disorder and episodes
of fainting. The pauses (1 and 1.44 seconds) are greater
than twice the normal R-R interval (0.46). (From: Tille
y, L.P. Essentials of canine and feline electrocardiogr
aphy. 3rd ed. Baltimore: Williams & Wilkins, 1992, with
permission.)
Topic-Sinus Arrhythmia

Figure 1. Sinus bradycardia at a rate of 75 beats/


minute in a cat during anesthetic complications during
surgery. (From: Tilley, L.P. Essentials of canine and
feline electrocardiography. 3rd. ed. Baltimore: Williams
& Wilkins, 1992, with permission.

Figure 1. Respiratory sinus arrhythmia with an average


rate of 120/minute (paper speed, 25 mm/second; 6
complexes between 1 set of time lines m 20). The rate
increases during inspiration (INSP) and decreases
during expiration (EXP). The fluctuation of the baseline
correlates with the movement of the electrodes by the
thoracic cavity. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Baltimore:
Williams & Wilkins, 1992, with permission.)

Topic-Sinus Tachycardia
Figure 1. Sinus tachycardia at a rate of 272/minute in
a
dog in shock. The rhythm is sinus because the P waves a
re normal, the P-R relationship is normal, and the rhyt
hm is regular. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Baltimore: Wil
liams & Wilkins, 1992, with permission.)
Topic-Supraventricular Tachycardia
Figure 1. Sinus with an atrial premature complex
and paroxysmal supraventricular tachycardia. Abrupt
initiation and termination of the tachycardia help
distinguish it from sinus tachycardia (lead II, 50 mm/
second, 1 cm = 1 mV). (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd ed.
Baltimore: Williams & Wilkins, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic-Syncope
Figure 1
Topic-Tetralogy of Fallot
Figure 1. Classic Tetralogy of Fallot.
Topic-Ventricular Arrhythmias and Sudden Death
in German Shepherds
Figure 1. Example of ventricular arrhythmia seen in
severely affected German shepherds with inherited
arrhythmias and propensity for sudden death. Courtes
y of Sydney Moise.
Figure 2. Example of ventricular arrhythmia seen in
severely affected German shepherds with inherited
arrhythmias and propensity for sudden death.Courtesy
of Sydney Moise.

Figure 5. Example of ventricular arrhythmia seen in


severely affected German shepherds with inherited
arrhythmias and propensity for sudden death. Courtes
y of Sydney Moise.
Topic-Ventricular Fibrillation
Figure 1. Coarse ventricular fibrillation. (From: Tilley,
L.P. Essentials of canine and feline electrocardiograph
y. 3rd ed. Baltimore: Williams & Wilkins, 1992, with p
ermission.)
Figure 2. Ventricular flutter-fibrillation in a cat with
severe myocardial damage from an 11-story fall. The
complexes are very wide, bizarre, tall, and rapid.
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Baltimore: Williams &
Wilkins, 1992, with permission.)

Figure 3. Example of ventricular arrhythmia seen in


severely affected German shepherds with inherited
arrhythmias and propensity for sudden death. Courtes
y of Sydney Moise.
Figure 4. Example of ventricular arrhythmia seen in
severely affected German shepherds with inherited
arrhythmias and propensity for sudden death. Courtes
y of Sydney Moise.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Topic- Ventricular Premature Complexes

Topic- Ventricular Septal Defect

Figure 1. VPC and a fusion complex (fifth complex)


in a dog with myocarditis from a pancreatitis. A
fusion complex is the simultaneous activation of the
ventricle by impulses coming from the SA node and
the ventricular ectopic foci. The QRS complex is
intermediate in form. (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd ed.
Baltimore: Williams & Wilkins, 1992, with permissio
n.)
Figure 2. Ventricular bigeminy. Every other complex
is a VPC from the same focus. Each is coupled (int
erval the same between it and the adjacent sinus co
mplex) to the preceding normal complex. (From: Till
ey, L.P. Essentials of canine and feline electrocar
diography. 3rd ed. Baltimore: Williams & Wilkins,
1992, with permission.)

Figure 1. Ventricular septal defect. The defect is


an unobstructed communication. Right ventricular
hypertrophy and pulmonary hypertension are
associated. Left-to-right shunting is shown. RA =
right atrium, LA = left atrium, RV = right ventricle,
LV = left ventricle, AO = aorta, PT = pulmonary trunk.
(From: Roberts, W. Adult Congenital Heart Disease.
Philadelphia: F.A. Davis, 1987, with permission.)
Figure 2. Angiocardiogram of ventricular septal defect.
Figure 3. Necropsy specimen of ventricular septal
defect.
Topic-Ventricular Standstill (Asystole)
Figure 1. Ventricular asystole in a dog with severe
complete AV block. Only P wages (atrial activity) are
present; there is no ventricular activity. (Lead II, 50
mm/ second, 1 cm = 1 mV) (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd ed. Blackw
ell Publishing, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology
Figure 2. Ventricular asystole in a cat with severe
hyperkalemia (11 mEq/L) from urethral obstruction. No
P waves or QRS complexes are seen after four wide
and nozaree QRS complexes (atrial standstill with
delayed ventricular conduction). (lead II, 50 mm/sec, 1
cm = 1 mV) (From: Tilley LP: Essentials of canine and
feline electrocardiography. 3rd ed. Blackwell Publishing
, 1992, with permission.)
Topic- Ventricular Tachycardia
Figure 1. Ventricular tachycardia. The wide and bizarre
QRS complexes occur at a rate of 160 beats/minute,
with no relationship to the P waves. There are more
QRS complexes than P waves. Ventricular tachycardia
should be treated as soon as possible. Acid-base and
electrolyte abnormalities should always be corrected.
(From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Baltimore: Williams &
Wilkins, 1992, with permission.)

Topic- Wolff-Parkinson-White Syndrome


Figure 1. Wolff-Parkinson-White syndrome (canine).
Ventricular pre-excitation represented by the short
P-R interval, wide QRS complex, and delta wave
(arrow) in CV6LU. Paroxysms of supraventricular
tachycardia are represented in the long lead II rhythm
strip. (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992
, with permission.)
Figure 2. Ventricular pre-excitation in a cat with
episodes of fainting. The P waves are normal, the P-R
interval is short, and the QRS complex is wide; delta
waves (arrow) are present. (From: Tilley, L.P. Essentia
ls of canine and feline electrocardiography. 3rd ed. Bl
ackwell Publishing, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valvular Stenosis


Figure 1. M-mode image recorded at the mitral valve level showsa thickened mitral
valve with concordant motion of the anteriorand posterior mitral valve leaflets (arrow).
RV = right ventricle, LV = left ventricle, MV = mitral valve, IVS =
interventricularseptum, LVPW = left ventricular posterior wall.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valvular Stenosis


Figure 2. Spectral Doppler of mitral inflow in a dog with mitral stenosis shows prolonged
pressure half-time (P1/2t) of 311ms (normal <50ms) and elevated mean pressure
gradient (mean PG) of 14mmHg (normal <5mmHg).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valvular Stenosis


Figure 3. Spectral Doppler of mitral inflow in the same dog as figure 4 when the dogs heart
rate accelerated. Note the increased mean pressure gradient (mean PG) of 22mmHg at a
heart rate of 191bpm versus 14mmHg in Figure 4 when the heart rate was 120bpm.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valvular Stenosis


Figure 4. Spectral Doppler of mitral inflow in a dog with mitral stenosis, mitral regurgitation
(MR) and atrial fibrillation. Note the prolonged pressure half-time during diastolic filling. A
faint jet of mitral regurgitation (MR) is also evident. Due to the atrial fibrillation the A-wave of
mitral inflow is absent. Note the end-diastolic velocity is lower with long diastolic cycles
indicative of the reduced pressure gradient associated with a lower heart rate.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 1. Intraoperative photograph of a patent ductus arteriosus (PDA) in a cat. The very
large ductus (arrow) evident in this case extends from the descending aorta (just below the
red rubber tube) to the origin of the left pulmonary artery (PA). Two ligatures have been
passed around the ductus.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 2. Angiocardiogram showing contrast opacification of the ascending aorta and aortic
arch (Arch), ductus arteriosus (DA) and entry of the ductus into the pulmonary artery
(arrow). Due to left-to-right shunting the pulmonary arterial system is partially illuminated
with contrast.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 3. Lateral radiograph obtained from a dog with a left to right shunting PDA. The left
ventricle is enlarged leading to elongation of the heart (double arrow). The left atrium (LA)
is markedly dilated. There is pulmonary overcirculation especially evident in the
caudodorsal lung fields. The cranial pulmonary vein is distended (single arrows).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 4. Dorsoventral (left) and ventrodorsal (right) radiographs obtained from two dogs with PDA.
Left: a left to right shunting PDA with cardiac elongation from left ventricular dilation, a prominent
left auricular bulge (right arrow), and dilation of the descending aorta or ductus bump (at the edge
of the two arrows). Right: a right to left shunting PDA with prominence of the right ventricle and
dilation of the main pulmonary artery (top arrow) and lobar arteries (the left caudal branch is shown
by the two arrows).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 5. Echocardiogram from a dog with PDA. Left cranial transducer position. The ductal
ampulla (PDA) is evident in both images showing the connection to the pulmonary artery
(PA). The color Doppler image shows turbulent flow from the PDA tracking along the edge
of the PA (arrowheads). Ao=aorta; RV=right ventricle.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 6. Continuous wave Doppler image from the pulmonary artery recorded in a dog
with left to right shunting PDA. High velocity, continuous flow is evident entering the PA
from the ductus.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 7. Echocardiographic images obtained from two cases of right to left shunting PDA.
Left: 2D image obtained from a cat shows a dilated ductus (arrow) entering the origin of the
left pulmonary artery. The main pulmonary artery (PA), right (rPA) and left (LPA) are dilated
due to pulmonary hypertension. Right: Spectral Doppler image obtained from a dog
showing low velocity bidirectional flow typical of reversed PDA. There is left to right
shunting in systole and right to left shunting in diastole.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 8. Amplatz designed ductal occluder within a ductus arteriosus. The silhouette of the
device is evident with a flat disc on the pulmonary arterial side of the duct (arrow) and a
cup-like disc within the distal ductal ampulla. The two discs are more evident within the
magnified image (inset). The development of this device specifically for dogs has provided
an effective, minimally-invasive solution for ductal closure.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Stenosis


Figure 1. Angiogram of aortic stenosis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Stenosis


Figure 2. Postmortem of a dog with subaortic stenosis demonstrating
left ventricular (LV) hypertrophy, aortic post-stenotic dilation (Ao), and a
subvalvular fibrous ridge (instrument pointer).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Stenosis


Figure 3. Two-dimensional echocardiograph, right parasternal long axis
view, demonstrating a subvalvular ridge typical of subaortic stenosis.
Thickening of the anterior mitral valve leaflet (MV) is also apparent. Aorta
(Ao), left ventricle (LV), and left atrium (LA).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Stenosis


Figure 4. Similar to 1A with color flow Doppler overlay demonstrating
turbulent flow distal to the obstruction.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 1.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 2. A cat with thrombus of the left forelimb.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 3. A cat with thrombus and cyanotic pads.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 4. Postmortem thrombus in a cat.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 5. Aortic thromboembolism.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 6. Aortic thromboembolism.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Aortic Thromboembolism


Figure 7. Aortic thromboembolism.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ascites
Figure 1. Ascites in a doglateral radiography.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ascites
Figure 2. A dog with ascites.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Fibrillation and Atrial Flutter


Figure 1. Atrial flutter with 2:1 conduction at ventricular rate of 330/minute
in a dog with an atrial septal defect. This supraventricular tachycardia
was associated with a Wolff-Parkinson-White pattern. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography, 3rd ed. Baltimore:
Williams & Wilkins, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Fibrillation and Atrial Flutter


Figure 2. Coarse atrial fibrillation in a dog with patent ductus arteriosus.
The f waves are prominent. (From: Tilley, L.P. Essentials of canine and
feline electrocardiography, 3rd ed. Baltimore: Williams & Wilkins, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Premature Complexes


Figure 1. APC in a dog. P9 represents the premature complex. The
premature QRS resembles the basic QRS. The upright P9 wave is
superimposed on the T wave of the preceding complex. APC. (From: Tilley,
L.P. Essentials of canine and feline. 3rd ed. Blackwell Publishing, 1992,
with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Premature Complexes


Figure 2. APCs in bigeminy in a cat under general anesthesia. The second
complex of each pair is an APC, where the first is a sinus complex. The
abnormality in rhythm disappeared after the anesthetic was stopped.
(From: Tilley, L.P. Essentials of canine and feline electrocardiography. 3rd
ed. Blackwell Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Septal Defect


Figure 1. Atrial septal defect. Defect involves the lowermost part of the
atrial septum, known as ostium primum defect. Note the left dominant lefttoright shunt. RV = right ventricle, LV = left ventricle, RA = right atrium,
Ao = aorta, PT = pulmonary trunk. (From Roberts W. Adult congenital heart
disease. Philadelphia: FA Davis Co., 1987, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Standstill


Figure 1. Persistent atrial standstill in English springer spaniel. No P
waves are present on any of the leads (also including chest leads and
intracardiac electrocardiogram, not shown here). The regular bradycardia
is either junctional in origin, with pathologic involvement of the left bundle
branch block (wide positive QRS complexes), or ventricular. (From: Tilley,
L.P. Essentials of canine and feline electrocardiography. 3rd ed. Baltimore:
Williams & Wilkins, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Wall Tear


Figure 1. Gross specimenleft atrial tear
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Wall Tear


Figure 2. Right parasternal short axis echocardiographic image at the level
of the aorta and left atrium. The arrow points to an intra-atrial thrombus
attached to the atrial wall at the junction of the body of the left atrium and
the left auricular appendage. Severe left atrial enlargement and pericardial
effusion are present. LAA= Left auricular appendage; LA=Left atrium;
PE=Pericardial effusion.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Wall Tear


Figure 3. Right parasternal short axis echocardiographic image at the level
of the left ventricle (LV). Pericardial effusion is noted and a characteristic
linear thrombus is seen within the pericardial sac adjacent to the LV. LV=
left ventricle; PE=pericardial effusion.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrial Wall Tear


Figure 4. Gross cardiac specimen from a dog with advanced mitral
endocardiosis that died following an acute left atrial tear. The probe is
pointing to a 2 cm tear in the left atrial wall at the junction of the body of
the left atrium and left auricular appendage. LAA=left auricular appendage;
LA=left atrium. Photo courtesy of Dr. Richard Jakowski.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, Complete (Third Degree)


Figure 1. Complete heart block. The P waves occur at a rate of 120,
independent of the ventricular rate of 50. The QRS configuration is a right
bundle branch block pattern. The regular rate and stable QRS indicate
that the rescuing focus is probably near the AV junction. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, Complete (Third Degree)


Figure 2. Complete heart block in a cat. The P waves rate is 240/minute,
independent of the ventricular rate of 48/minute. QRS configuration is a
left bundle branch block pattern. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, Complete (Third Degree)


Figure 3. Lateral radiograph of a dog with transvenous pacemaker.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, First Degree


Figure 1. Lead II ECG rhythm strip recorded from a cat with hypertrophic
cardiomyopathy. There is sinus bradycardia (120 beats/minute) and first
degree atrioventricular conduction block. The PR interval is 0.12 second.
(paper speed = 50 mm/s)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, First Degree


Figure 2. Lead II ECG rhythm strip recorded from a dog showing sinus
tachycardia (175 beats/minute) and first degree atrioventricular conduction
block. Because the heart rate is rapid, P waves are superimposed on
the downslope of the preceding T waves. The PR interval exceeds 0.16
second. (paper speed = 50 mm/s)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, Second Degree - Mobitz Type I


Figure 1. Lead II ECG strip recorded from a dog with Mobitz type I, second
degree AV block. The PR intervals become progressively longer with the
longest PR intervals preceding nonconducted P waves (typical Wenkebach
phenomenon). (paper speed = 50 mm/s)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Block, Second Degree Mobitz Type II


Figure 1. Lead II ECG rhythm strip recorded from a dog with both firstand
second-degree atrioventricular block. The second-degree AV block
is high grade with both 2:1 and 3:1 block resulting in variation in the RR
intervals. The PR interval for the conducted beats is prolonged but constant
(0.28 second) (paper speed = 25 mm/s).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valve Dysplasia


Figure 1. Lateral radiographs of mitral valve dysplasia.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valve Endocardiosis


Figure 1. Postmortem of valvular endocardiosis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Atrioventricular Valve Endocardiosis


Figure 2. Lateral radiograph of mitral valve endocardiosis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Dilated Cats


Figure 1. Postmortem of dilated cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Dilated Cats


Figure 2. Echocardiogram of dilated cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Dilated Dogs


Figure 1. Gross postmortem of dilated cardiomyopathy (dog).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Dilated Dogs


Figure 2. Electrocardiographic findings.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 1. Dyspnea in a cat.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 2. Chest radiograph (lateral) of hypertyrophic cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 3. Chest radiography (dorsoventral) of hypertrophic cardiomyopathy cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 4. Echocardiogram of hypertrophic cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 5. Gross postmortem of hypertrophic cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Hypertrophic Cats


Figure 6. Angiocardiogram of hypertrophic cardiomyopathy (cat).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Cardiomyopathy, Restrictive Cats


Figure 1. Cardiomyopathy, restrictivecats.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Left-Sided


Figure 1. Dyspnea in a cat.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Left-Sided


Figure 2. Cachexia in a dog.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Right-Sided


Figure 1. Ascites in a doglateral radiography.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Right-Sided


Figure 2. Ascites in a doglateral radiography.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Right-Sided


Figure 3. Jugular distension in a cat with right-sided congestive heart failure.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Congestive Heart Failure, Right-Sided


Figure 4. Abdominal venous distension in a dog with right-sided heart failure.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Digoxin Toxicity


Figure 1. Sagging type of S-T segment depression in a dog with digitalis
toxicity.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Endocarditis, Infective


Figure 1. Gross postmortem of bacterial endocarditis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Endocarditis, Infective


Figure 2. Echocardiogram of bacterial endocarditis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Endocarditis, Infective


Figure 3. Echocardiogram of bacterial endocarditis.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Cats


Figure 1. Gross postmortem of heartworm disease in cat.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Dogs


Figure 1a. Microfilaria of dirofilaria and acanthocheilonema (Justin A.
Thomason).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Dogs


Figure 1b. Microfilaria of dirofilaria and acanthocheilonema (Justin A.
Thomason).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Dogs


Figure 2. Dorsoventral radiograph of heartworm disease in a dog.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Dogs


Figure 3. Echocardiogram of heartworm disease.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Heartworm Disease Dogs


Figure 4. Gross postmortem of heartworm disease in a dog.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Idioventricular Rhythm


Figure 1. Ventricular escape complexes (arrows) during various phases
in the dominant sinus rhythm in a dog during anesthesia. The sinus rate
increased (not shown) after anesthesia was stopped; 1/2 cm1 mv. (From:
Tilley, L.P. Essentials of canine and feline electrocardiography. 3rd ed.
Blackwell Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Idioventricular Rhythm


Figure 2. Complete heart block. The P waves occur at a rate of 120,
independent of the ventricular rate of 50. The QRS configuration is a right
bundle branch block pattern. The regular rate and stable QRS indicate
that the rescuing focus is probably near the AV junction. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Left Anterior Fascicular Block


Figure 1. Left anterior fascicular block in a cat with hypertrophic
cardiomyopathy. Severe left axis deviation (2608) with a qR pattern in
leads I and aVL and an rS pattern in leads II, III, and aVF. The QRS
complexes are of normal duration. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Left Anterior Fascicular Block


Figure 2. Left anterior fascicular block in a dog with hyperkalemia (serum
potassium, 5.3 mEq/L). There is abnormal left axis deviation (260_) with
a qR pattern in leads I and aVL and an rS pattern in leads II, III, and aVF.
The large T waves are compatible with hyperkalemia. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Left Bundle Branch Block


Figure 1. Left bundle branch block in a cat with hypertrophic
cardiomyopathy. The QRS complex is of 0.07-second duration and is
positive in leads I, II, III, aVF. Neither a Q wave nor an S wave occurs in
these leads. The QRS complex is inverted in leads aVR. (From: Tilley,
L.P. Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Left Bundle Branch Block


Figure 2. Intermittent left bundle branch block in a Chihuahua. QRS
complexes are wider (0.070.08 second) in the second, third, and fourth
complexes and in the last three complexes. Consistent P-R interval
confirms a sinus origin for the abnormal-appearing QRS complexes (lead
II, 50 mm/second, 1 cm 5 1 mV). (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Murmurs, Heart


Figure 1. Differential diagnosis of cardiac disease based on the timing and
location of murmurs. (Adapted from Allen, D.G. Murmurs and abnormal
heart sounds. By permission of Mosby-Year Book, Inc. In: Allen, D.G.,
Kruth, S.A., eds. Small animal cardiopulmonary medicine. Philadelphia: BC
Decker, 1988:13.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Myocardial Infarction


Figure 1. Transmural infarction of the left ventricle in a dog with
arteriosclerosis and hypothyroidism. The first three rapid successive
complexes represent ventricular tachycardia. The sinus rhythm that follows
illustrates small complexes, marked elevation of the S-T segment, and first
degree AV block (prolonged P-R interval). (From: Tilley, L.P. Essentials of
canine and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992,
with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 1. Angiocardiogram of patent ductus arteriosus.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Patent Ductus Arteriosus


Figure 2. Patent ductus arteriosus.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pericarditis
Figure 1. The photograph demonstrates catheter positioning and
orientation for pericardiocentesis from the right ventral approach. While
stabilizing the catheter near the entry point with one hand, the catheter
is advanced in a cranial and dorsal direction with the other, i.e. towards
the opposite scapula. A small degree of suction is maintained with the
syringe so that pericardial fluid is aspirated at the moment of pericardial
penetration. Subsequently the syringe and stylet are held stationary while
the flexible catheter is advanced well into the pericardium. The sharp
metal stylet is withdrawn after the catheter is fully positioned.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pericarditis
Figure 2. Echocardiograph acquired with transducer at the same location
and orientation (direction) as the catheter shown above. Dotted line
indicates structures encountered by the central ultrasound beam, i.e. in
the path of the catheter. While this patient had a relatively small amount
of pericardial effusion (PE), proper catheter positioning, orientation, and
linear advancement minimizes risk. Oblique orientation of the catheter,
relative to the cardiac surface, increases the effective distance between the
pericardium and heart.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pericarditis
Figure 3. Instrumentation used for pericardiocentesis. A 14g 5catheter
and stylus are shown with a small syringe attached, i.e. configured to
advance into the pericardial space. The sharp metal stylus is removed
after the catheter is fully positioned, as demonstrated for the 16g
5catheter, and an extension tube attached to the catheter for aspiration
using a larger syringe and 3-way stopcock. An 18g 2 catheter is used for
cats and similarly sized dogs. A #11 blade is ideal for creating a small stab
incision at the site of entry. The author uses a #10 blade to cut side holes
in the distal end of the larger catheters (optional).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pleural Effusion


Figure 1. Dyspnea in a cat.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pleural Effusion


Figure 2. Radiograph of pleural effusionlateral (dog).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pulmonic Stenosis


Figure 1. Ventrodorsal radiograph of a dog with pulmonic stenosis. There is
a marked right ventricular enlargement, with the apex shifted to the left. A
prominent pulmonary artery bulge is visible (arrow) (Virginia Luis Fuentres).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pulmonic Stenosis


Figure 2. Two-dimensional echocardiographic right parasternal long axis
view of a dog with severe pulmonic stenosis. The right ventricular free wall
and interventricular septum are very hypertrophied, with mild right atrial
enlargement (Virginia Luis Fuentres).
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Pulmonic Stenosis


Figure 3. Continuous wave spectral Doppler recording of pulmonary
artery flow from a left cranial view in a dog with severe pulmonic stenosis.
Pulmonary artery velocities are greatly increased (approximately 5 m/s).

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Right Bundle Branch Block


Figure 1. Right bundle branch block in a dog. The electrocardiographic
features include QRS duration of 0.08 second; positive QRS complex in
aVR, aVL, and CV5RL (M-shaped); and large wide S waves in leads I, II,
III, and aVF. There is a right axis deviation (approximately 110) (50 mm/
second, 1 cm 5 1 mV). (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Right Bundle Branch Block


Figure 2. Right bundle branch block in a cat with the dilated form of
cardiomyopathy. The QRS duration is 0.08 second (4 boxes). Large and
wide S waves are present in leads I, II, III, aVF, and CV6LU. The QRS in
CV5RL has a wide R wave (M-shaped). There is a marked axis deviation
(approximately 90 ). (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Blackwell Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Sick Sinus Syndrome


Figure 1. A continuous lead II ECG rhythm strip recorded from a dog with
sick sinus syndrome. The dogs rhythm is initially an ectopic atrial rhythm
(negative P waves; heart rate 187 beats/minute) followed by asystole of
more than 10 seconds duration which is terminated by a junctional escape
complex. Four sinus complexes precede a brief sinus pause that is again
terminated by a junctional escape complex. The ectopic atrial rhythm then
resumes. (paper speed = 50 mm/s)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Sinus Arrest and Sinoatrial Block


Figure 1. Intermittent sinus arrest in a brachycephalic breed with an upper
respiratory disorder and episodes of fainting. The pauses (1 and 1.44
seconds) are greater than twice the normal R-R interval (0.46). (From:
Tilley, L.P. Essentials of canine and feline electrocardiography. 3rd ed.
Baltimore: Williams & Wilkins, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Sinus Arrhythmia


Figure 1. Respiratory sinus arrhythmia with an average rate of 120/
minute (paper speed, 25 mm/second; 6 complexes between 1 set of time
lines m 20). The rate increases during inspiration (INSP) and decreases
during expiration (EXP). The fluctuation of the baseline correlates with
the movement of the electrodes by the thoracic cavity. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography. 3rd ed. Baltimore:
Williams & Wilkins, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Sinus Bradycardia


Figure 1. Sinus bradycardia at a rate of 75 beats/minute in a cat during
anesthetic complications during surgery. (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd. ed. Baltimore: Williams &
Wilkins, 1992, with permission.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic-Sinus Tachycardia
Figure 1. Sinus tachycardia at a rate of 272/minute in a dog in shock. The
rhythm is sinus because the P waves are normal, the P-R relationship is
normal, and the rhythm is regular. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Baltimore: Williams & Wilkins, 1992,
with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Supraventricular Tachycardia


Figure 1. Sinus with an atrial premature complex and paroxysmal
supraventricular tachycardia. Abrupt initiation and termination of the
tachycardia help distinguish it from sinus tachycardia (lead II, 50 mm/
second, 1 cm = 1 mV). (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Baltimore: Williams & Wilkins, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Syncope
Figure 1.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Tetralogy of Fallot


Figure 1. Classic Tetralogy of Fallot.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Arrhythmias and Sudden Death in


German Shepherds
Figure 1. Example of ventricular arrhythmia seen in severely affected
German shepherds with inherited arrhythmias and propensity for sudden
death. Courtesy of Sydney Moise.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Arrhythmias and Sudden Death in


German Shepherds
Figure 2. Example of ventricular arrhythmia seen in severely affected
German shepherds with inherited arrhythmias and propensity for sudden
death.Courtesy of Sydney Moise.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Arrhythmias and Sudden Death in


German Shepherds
Figure 3. Example of ventricular arrhythmia seen in severely affected
German shepherds with inherited arrhythmias and propensity for sudden
death. Courtesy of Sydney Moise.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Arrhythmias and Sudden Death in


German Shepherds
Figure 4. Example of ventricular arrhythmia seen in severely affected
German shepherds with inherited arrhythmias and propensity for sudden
death. Courtesy of Sydney Moise.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Arrhythmias and Sudden Death in


German Shepherds
Figure 5. Example of ventricular arrhythmia seen in severely affected
German shepherds with inherited arrhythmias and propensity for sudden
death. Courtesy of Sydney Moise.
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Fibrillation


Figure 1. Coarse ventricular fibrillation. (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd ed. Baltimore: Williams &
Wilkins, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Fibrillation


Figure 2. Ventricular flutter-fibrillation in a cat with severe myocardial
damage from an 11-story fall. The complexes are very wide, bizarre,
tall, and rapid. (From: Tilley, L.P. Essentials of canine and feline
electrocardiography. 3rd ed. Baltimore: Williams & Wilkins, 1992, with
permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Premature Complexes


Figure 1. VPC and a fusion complex (fifth complex) in a dog with
myocarditis from a pancreatitis. A fusion complex is the simultaneous
activation of the ventricle by impulses coming from the SA node and the
ventricular ectopic foci. The QRS complex is intermediate in form. (From:
Tilley, L.P. Essentials of canine and feline electrocardiography. 3rd ed.
Baltimore: Williams & Wilkins, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Premature Complexes


Figure 2. Ventricular bigeminy. Every other complex is a VPC from the
same focus. Each is coupled (interval the same between it and the
adjacent sinus complex) to the preceding normal complex. (From: Tilley,
L.P. Essentials of canine and feline electrocardiography. 3rd ed. Baltimore:
Williams & Wilkins, 1992, with permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Septal Defect


Figure 1 Ventricular septal defect. The defect is an unobstructed
communication. Right ventricular hypertrophy and pulmonary hypertension
are associated. Left-to-right shunting is shown. RA = right atrium, LA = left
atrium, RV = right ventricle, LV = left ventricle, AO = aorta, PT = pulmonary
trunk. (From: Roberts, W. Adult Congenital Heart Disease. Philadelphia:
F.A. Davis, 1987, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Septal Defect


Figure 2. Angiocardiogram of ventricular septal defect.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Septal Defect


Figure 3. Necropsy specimen of ventricular septal defect.

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Standstill (Asystole)


Figure 1. Ventricular asystole in a dog with severe complete AV block. Only
P wages (atrial activity) are present; there is no ventricular activity. (Lead
II, 50 mm/second, 1 cm = 1 mV) (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Standstill (Asystole)


Figure 2. Ventricular asystole in a cat with severe hyperkalemia (11 mEq/L)
from urethral obstruction. No P waves or QRS complexes are seen after
four wide and nozaree QRS complexes (atrial standstill with delayed
ventricular conduction). (lead II, 50 mm/sec, 1 cm = 1 mV) (From: Tilley
LP: Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Ventricular Tachycardia


Figure 1. Ventricular tachycardia. The wide and bizarre QRS complexes
occur at a rate of 160 beats/minute, with no relationship to the P waves.
There are more QRS complexes than P waves. Ventricular tachycardia
should be treated as soon as possible. Acid-base and electrolyte
abnormalities should always be corrected. (From: Tilley, L.P. Essentials
of canine and feline electrocardiography. 3rd ed. Baltimore: Williams &
Wilkins, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic- Wolff-Parkinson-White Syndrome


Figure 1. Wolff-Parkinson-White syndrome (canine). Ventricular preexcitation
represented by the short P-R interval, wide QRS complex, and
delta wave (arrow) in CV6LU. Paroxysms of supraventricular tachycardia
are represented in the long lead II rhythm strip. (From: Tilley, L.P.
Essentials of canine and feline electrocardiography. 3rd ed. Blackwell
Publishing, 1992, with permission.)
Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition
Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

Cardiology

Topic-Wolff-Parkinson-White Syndrome
Figure 2. Ventricular pre-excitation in a cat with episodes of fainting. The P
waves are normal, the P-R interval is short, and the QRS complex is wide;
delta waves (arrow) are present. (From: Tilley, L.P. Essentials of canine
and feline electrocardiography. 3rd ed. Blackwell Publishing, 1992, with
permission.)

Blackwells Five-Minute Veterinary Consult: Canine and Feline, Sixth Edition


Edited by Larry Patrick Tilley and Francis W. K. Smith, Jr. 2016 by John Wiley & Sons, Inc.

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