Page 2200 - Cote clinical veterinary advisor dogs and cats 4th

1096 Electrocardiography

VetBooks.ir RV LV

RA
Ao
LA

ECHOCARDIOGRAPHY Five-chamber view is obtained at left apical parasternal
location. Left apical parasternal location is the only time during echocardiographic
examination when the index mark on the head of transducer is directed caudally.
Ao, Aorta; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
ECHOCARDIOGRAPHY Remaining in the same right parasternal window as the
two previous views, gently pivoting toward the heart base, the right parasternal,
short-axis view at the left atrium/aorta level was obtained in the same dog. AS, Atrial • Cardiac neoplasms may be best imaged when
septum; LA, left atrium; LAu, left auricle; LC, left coronary cusp; NC, noncoronary some pericardial fluid is present.
cusp; PVs, pulmonic valve; RC, right coronary cusp; RV, right ventricle. • To reduce the risk of false-positive (pseudotu-
mor) and false-negative (missed lesion) results
for neoplasms, it is critical to demonstrate a
inflow tract should be to the left and the Pearls mass convincingly in more than one view.
outflow tract and pulmonary artery to the • Patient positioning with the limbs toward SUGGESTED READING
right. the ultrasonographer in left or right lateral Bélanger MC: Echocardiography. In Ettinger SJ, et al,
recumbency makes patient restraint easier if
Postprocedure only one person is available to restrain the editors: Textbook of veterinary internal medicine, ed
7, St. Louis, 2010, Saunders Elsevier, pp 415-431.
• Remove ECG clips. patient.
• Wipe gel and alcohol from animal. • The long axis of a cat’s heart tends to become Reproduced from the third edition in
more parallel to the sternum as a cat ages; unabridged form.
Alternatives and Their therefore, the angle of the ultrasound probe
Relative Merits will be different for a 16-year-old cat versus a AUTHOR: Robert Prošek, DVM, MS, DACVIM, DECVIM
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
Transesophageal echocardiography: 2-year-old. Imaging the position of the heart Thompson, DVM, DABVP
• Semi-invasive procedure in the thorax and how it changes with age
• Requires general anesthesia in animals allows better probe placement and reduces
• Provides superb clarity and resolution frustration greatly.

Electrocardiography

Difficulty level: ♦♦ • Syncope/weakness events • Isopropyl alcohol or conducting gel
• Episodic clinical signs of uncertain type but • ± Cutaneous cardiac electrode adhesive
Synonyms that might represent syncope patches
Electrocardiogram (ECG), EKG, electrocar- • Screening of breeding or at-risk animals • Nonconductive surface (i.e., mat on floor or
diography (boxers, Dobermans) for latent arrhythmias top of table for patient to lay on, reducing
• Evaluation of a patient with suspected electrical interference)
Overview and Goal hyperkalemia
To assess the cardiac electrical activity and • Monitoring during pericardiocentesis (p. Anticipated Time
cardiac rhythm in a clinical setting and 1150) Five minutes, possibly longer if looking for
may provide some information about cardiac infrequent arrhythmias, although a Holter
chamber enlargement, electrolyte abnormalities Contraindications monitor would be better for this (p. 1120)
(hyperkalemia [p. 495]), or metabolic distur- Tachypnea/dyspnea: relative contraindication
bances (hypoxia). for typical lateral restraint, but ECG can Preparation: Important
be done with patient standing or sternal Checkpoints
Indications rather than standard right lateral position if • Input patient information into the machine,
• Cardiac arrhythmia detected on physical indicated if applicable.
examination (bradycardia, tachycardia, • Ensure sufficient paper loaded in the
irregular rhythm) Equipment, Anesthesia machine.
• Part of routine monitoring or part of a pre- • ECG machine: machine, paper (if applicable), • Patient should be placed on mat in right
anesthetic evaluation for patients going under leads with atraumatic clips to connect to lateral recumbency (standard normal values
general anesthesia patient’s skin were derived from this position).

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