Cardiac vs. Pulmonary Disease
Table of Contents
FastTrack Complete Report: Cardiac vs. Pulmonary Disease
Table of Contents
1. Purpose & Use - Case type
2. X-RAY Signals to Be Assessed
A. Cardiovascular System
B. Respiratory System
C. Additional Findings including the thorax, abdomen and musculoskeletal regions
1. Purpose & Use - Case Type
This FastTrack Complete Report will help determine if the respiratory signs are primarily due to cardiac disease (heart-related) or pulmonary disease(lung/airway-related). In addition to answering this core question, the report will highlight any high-value radiographic findings such as masses, hernias, or gas in the thorax, that may not be directly related to presenting problem but are important to identify due to their potential impact on case management and patient outcomes.
Scenarios when to use this FastTrack Complete Report:
- Clinical signs that may arise from either cardiac or pulmonary pathology, including heart murmur/arrhythmia, respiratory distress, coughing, and/or syncopal episodes, but the underlying cause remains undetermined.
- Further imaging interpretation is needed to help differentiate whether the primary cause of clinical signs is heart-related or lung-related.
- Radiographic findings suggest a mixed or overlapping etiology, such as concurrent cardiomegaly and a cranioventral parenchymal pattern, requiring a more comprehensive review to clarify the predominant disease process or primary differential diagnosis.
Clinical Signs Checklist (when submitting):
The clinical signs checklist is used to summarize key clinical signs that are relevant to the current concern. It provides a quick reference to observable or reported signs, helping ensure that radiographic findings are interpreted in an appropriate clinical context. This checklist will primarily include the following;
Primarily Cardiac-Related Signs:
- Heart murmur
- Arrhythmia (Irregular heartbeat)
- Respiratory distress (Trouble breathing)
- Breathing faster than normal
- Exercise intolerance - reduced ability to perform physical activity or exercise
- Fainting or collapse (Syncopal episodes)
- Weak femoral pulses - indicating diminished arterial blood flow or reduced cardiac output to the peripheral circulation.
- Coughing (cardiac-related) - Often dry, harsh, or non-productive cough that worsens at night or when lying down and is often exacerbated by exercise or excitement. This may be chronic or intermittent and may be associated with tachypnea or dyspnea
- Hemoptysis (Coughing up blood)
Primarily Pulmonary-Related Signs:
- Coughing (pulmonary-related) - Often moist, productive, or soft cough that may produce mucus or phlegm (though this is not always evident in dogs). It is persistent or paroxysmal (sudden bouts) and may also be accompanied by other respiratory signs such as nasal discharge, wheezing, or abnormal lung sounds.
- Hemoptysis (Coughing up blood)
- Breathing difficulty (labored or difficult breathing-manifests as increased respiratory effort or rate)
-
Abnormal lung sounds - audible sounds detected during thoracic auscultation that indicate disease of the airways, lung parenchyma, or pleural space
- Crackles - Air passing through fluid-filled or collapsed alveoli. Often due to pulmonary edema, pneumonia, pulmonary fibrosis, hemorrhage
- Wheezing - Airflow through narrowed bronchi/bronchioles. Often due to asthma, chronic bronchitis, airway collapse
- Increased (Harsh or Bronchovesicular) Sounds - Increased turbulence through inflamed or narrowed airways. Often due to chronic bronchitis, early pneumonia, mild pulmonary edema
- Dull or Absent Lung Sounds - Lack of air movement or presence of pathology in the pleural space.
2. X-RAY Signals to Be Assessed
The FastTrack report focuses on key radiographic signals that are clinically relevant to the presenting clinical signs and help guide urgent decision-making. The following signals are systematically evaluated to identify abnormalities that may require immediate attention, further diagnostics, or clinical intervention.
A. Cardiovascular System
- General Cardiomegaly
- Left Atrial Enlargement
- Right Heart Enlargement
- Vertebral Heart Score
- Pulmonary Vessel Congestion
- Tortuous Pulmonary Vessels
B. Respiratory System
- Cranioventral Parenchymal Pattern
- Caudodorsal Parenchymal Pattern
- Diffuse Parenchymal Pattern
- Pleural Fluid
C. Additional Findings (Critical Radiographic Findings) based on submitted views.
Thorax
- Thoracic Mass
- Diaphragmatic Hernia
- Pneumothorax
- Esophageal Foreign Body
Abdomen
- Peritoneal Mass Effect
- Mid Abdominal Mass
- Limited Abdominal Detail
- Peritoneal gas
- Hepatomegaly
- Gastric Foreign Body
- Abdominal Hernia
Musculoskeletal
- Rib Fracture
- Vertebral Fracture
- Appendicular Fracture
- Skull Fracture
- Pelvic Fracture
- Bone Lesions