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1208.e2 Congestive Heart Failure: Physical Signs

Congestive Heart Failure: Physical Signs
VetBooks.ir Pulmonary Signs (Left-Sided CHF) from earliest to latest/most

severe
Dyspnea and discomfort during recumbency (orthopnea)
Shortness of breath, tachypnea
+/- Cough (seldom present without dyspnea in dogs [especially small-breed
dogs], almost never caused by CHF in cats)
Rales/crackles on auscultation (alveolar edema)
Frothy, pink sputum on expectoration
Signs Attributable to Either Left- or Right-Sided CHF
Weakness and fatigue (general exercise intolerance)
Exertional dyspnea
Gallop sound/“gallop rhythm” (accentuated third heart sound)
Poor peripheral perfusion: pale mucous membranes, slow capillary refill time,
mild cyanosis, cool extremities, weak pulse quality
Tachycardia
Weight loss (cardiac cachexia)
Systemic Signs (Right-Sided CHF)
Generalized venous engorgement, including hepatic venous congestion
identifiable on abdominal ultrasonography
Hepatomegaly
Body cavity effusions (modified transudate): ascites, pleural effusion,
pericardial effusion
Dependent peripheral edema
Weight gain (retained fluid)
CHF, Congestive heart failure.
Modified from Ettinger S, Feldman E: Textbook of veterinary internal medicine, ed 7, St. Louis,
2010, Saunders.

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