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Vertebral Heart Score (VHS)

Written by Orr Rubin

Updated at April 16th, 2025

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Vertebral Heart Score

This is used to assess the size of the heart in relation to the spine, allowing for a more objective assessment of heart size. This score is calculated by measuring the length and width of the heart and comparing these measurements against thoracic vertebrae starting at T4.

The VHS is considered normal if in;

  • Cats is 6.8 - 8.0 
  • Dogs is 8.5 - 10.6

Canine Feline

The VHS is considered abnormal if in;

  • Cats is > 8.0
  • Dogs is > 10.8

Canine Feline

The VHS will not be assessed in the following scenarios;

  • 4th or 5th thoracic vertebrae not visible

  • Border effacement of cardiac silhouette

  • Entire heart not visible

  • Poor image quality

  • Oblique/overly rotated image

  • Caudal vertebrae not in Field of View

  • Concurrent pathology affecting anatomic location/appearance of heart

  • Vertebral anomalies are present

vhs vertebral heart score heart score

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