Determine age, breed, and sex of the patient to help formulate a rule-out list and help to determine prognosis. Note current pre-existing diseases. Record current drugs and clinical response. Record presenting clinical signs and duration and progression of the illness.
The clinical signs of canine and feline heart failure are limited, but they must be distinguished from pulmonary dysfunction and also systemic problems. Heart disease often results in secondary respiratory signs (e.g., coughing or dyspnea); conversely, disease of the lung or its vasculature can result in secondary right heart disease (e.g., cor pulmonale).
Chronic heart failure (CHF) traditional therapy (for CHF secondary to chronic degenerative valvular disease etc.) still provides only an average a 4-6 months survival time in dogs. Though current standard treatment regimens provide a good quality of life for many canine patients, complications can lead to early patient loss.
The patient suspected of having a cardiac problem needs to have a complete history taken and physical examination performed; these procedures will establish the correct diagnosis and permit appropriate therapy. The cardiac examination is an extension of the complete physical examination.
Advancing technology has provided clinicians with ever more powerful and effective drugs for treating diseases. As more drugs become available, it becomes progressively more difficult to be aware of the numerous side effects, contraindications, and drug interactions of the many cardiopulmonary drugs available.
The essentials of electrocardiography include the assessment of heart rate, heart rhythm, and the P-QRS-T waveforms. The ECG is needed to accurately diagnose cardiac arrhythmias, and this test is extremely sensitive for this purpose.
Hypertension is often subclinical initially, and as the blood pressure increases, clinical signs may occur both due to the hypertension itself, or be linked to frequently associated medical conditions.