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Approach to the Patient with Suspected Cardiovascular Disease

Ingrid Ljungvall, DVM, PhD, DECVIM-CA (Cardiology) and Jens Häggström, DVM, PhD, DECVIM-CA (Cardiology)
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden

Suspicion of cardiac disease in dogs and cats may arise Species and Breed
due to information obtained from owner complaints Some specific heart diseases, both congenital and
and/or physical findings. Unfortunately, most of the acquired, are more commonly identified in individuals of
common clinical signs of heart disease are not specific certain breeds compared to others (see separate disease
for heart disease. Likewise, heart disease may occur con- chapters), which supports a genetic background for these
currently with other disease, making it unclear whether disorders.
the clinical signs are due to cardiac disease or something
else. The approach to the patient with suspected cardio-
vascular disease is therefore to obtain as much informa- Sex
tion as possible in order to make a correct diagnosis.
Very little is known concerning the effect of sex on the
prevalence of congenital heart disease in dogs and cats.
Signalment In most studies, no sex predilection has been reported.
However, sex appears to affect the prevalence of the
Signalment information is the first step in the clinical work‐ most common forms of acquired heart disease in dogs
up of a patient with suspected heart disease as some dis- (myxomatous mitral valve disease [MMVD] and dilated
eases are more commonly seen in specific types of animals. cardiomyopathy [DCM]) and cats (cardiomyopathy).
However, this type of data is only supportive in nature, and Males appear affected at an earlier age in both cats and
does not provide sufficient evidence for a definite diagnosis. dogs, which leads to a slightly higher proportion of
The signalment data should include information concern- affected individuals at a given age and a higher cause‐
ing age, species, breed, sex, and geographic location. specific mortality. The reason for this influence of sex is
unknown.
Age
Age can provide valuable information in a patient with Geographic Location
suspected cardiac disease; congenital heart disease,
which is defined as a heart defect present at birth, is more Information concerning the geographic origin of the pet
likely in young pets. However, congenital heart disease is important because the prevalence of certain congeni-
may remain undiscovered in middle‐aged or old dogs and tal and acquired heart diseases differs between conti-
cats not previously examined by a veterinarian. Acquired nents, countries, and even within countries. Again, this
heart disease, defined as a heart condition developing likely reflects different gene pools within breeds, but it
after birth, is most frequently found in middle‐aged and underlines the importance of interpreting results of dis-
old dogs and cats, although its presence in a younger ease prevalence with caution. It is also important to
individual cannot be excluded. For both dogs and cats, obtain information about where the animal has lived
presence of cardiac neoplasia is more common in older geographically because some diseases, for example para-
individuals. Extracardiac disease may affect the heart by sitic diseases (e.g., dirofilarosis), are prevalent in certain
causing myocyte damage in dogs and cats of any age. areas but nonexistent in others.

Clinical Small Animal Internal Medicine Volume I, First Edition. Edited by David S. Bruyette.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/bruyette/clinical