This document summarizes the clinical examination of the cardiovascular system in animals. It describes examining the heart through inspection, palpation, percussion, and auscultation. Auscultation is the primary method and involves listening for normal and abnormal heart sounds. Abnormal sounds include murmurs which can be systolic, diastolic, or continuous. The heart rate and rhythm are also examined. Additional examination involves the jugular vein, capillaries, and peripheral circulation.

1. Clinical
Examination
of
cardiovascular
system in
animals
Dr. Karima Al Salihi

2. The cardiovascular system
,consist of two main structural units
1. The Heart
2. Blood vessels
both of which are jointly involved in
Maintaining the circulation of the
blood and thereby ensuring normal
exchange of oxygen, carbon dioxide
dioxide, electrolytes, fluids, nutrients,
and waste products between the
blood and the tissue fluids and cells.

4. Examination of the
Heart
1. The position of the heart within
the thorax
The heart occupies the ventral
half of the thorax, in the lower two
thirds of the thoracic cavity
between the third to the sixth pairs
of ribs, suspended at its base by
the large blood vessels which
,traverse the mediastinum
and its apex lying in the midline
towards the sternum, slightly
towards the left

6. Anatomy of the heart:

7. Methods of physical examination of the heart:
The heart is examined by
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
All of these techniques can provide
information, but auscultation is the
fundamental component of the
examination of the heart.

8. Inspection:
Visible evidence of the contact of the heart with the chest may be
obtained by observing the so-called “apex beat” of the heart, causing
movement of the chest wall over a limited area of the fifth or sixth
intercostal space

9. Palpation:
Palpation may done to detect palpable vibration, or
thrill, exist with the cardiac cycle.
Palpation is performed by placing the fingers and the
palm of the hand over the anatomical area of the heart

10. Percussion:
Percussion is of limited value in the examination of the heart because
most of the heart underlies the muscles of the forelimbs and the
thoracic wall overlying the heart cannot be resonated

11. Auscultation
Auscultation of the heart will performed to determine the
1-Normal and abnormal sounds
2-The heart rate,
3-The heart rhythm
4-The intensity of heart sounds.

12. Rules of auscultation:
1-Optimum auscultation sites are the fourth and fifth left intercostal
space.
2-Manual extension of the forelimbs can facilitate auscultation of the
heart.
3-chest piece of the stethoscope must be pushed firmly against the
skin under the left elbow and the triceps muscle, with light pressure.
4- Examination should be conducted in a quiet environment

13. Heart sounds
1- Normal Heart sounds:
There are four sounds of the
heart. The first and second
sounds are clearly audible in
all normal animals. A third and
fourth sounds may be heard in
normal large animals,
particularly in horses.
First sound like “Lubb”:
It is associated with closure of
atrioventricular valves (mitral
and tricuspid).

14. Second sound like “Dubb”:
It is associated with closure of aortic and pulmonary valves.
Third sound
associated with rapid filling of the ventricle in early diastole.
Forth sound
associated with atrial contraction.

15. 2- Abnormal Heart sounds:
Abnormal heart sounds may originate
from the heart due to
1-Endocardial lesions and related to the
cardiac cycle,
or
2-From overpower normal heart sound
and not related to the cardiac cycle.

16. Cardiac murmurs:
Cardiac murmurs are audible vibrations
transmitted to the surface of the thoracic
wall, caused by turbulent blood flow inside
the heart due to endocardial lesions such as
insufficiency of valvular closure and
abnormal orifices.
Cardiac murmurs can be described
according to the cardiac cycle as
Systolic,
Diastolic
or
Continuous.

17. Systolic murmur:
Occurs during systole due to insufficiency in the atrioventricular
valves

18. Diastolic murmur:
Occurs during diastole due to insufficiency in mitral or pulmonic
valves

19. Continuous murmur:
begins in systole and continues into diastole.
It is occurs in the presence of abnormal
orifices in the heart, such as ductus
arteriosus, a defect where there is
continuous shunting of blood from aorta to
the main pulmonary artery.
Pericardial frictional rub:
This is audible vibration heard over the
thorax, produced by friction occurring with
movement of the heart in an inflamed
pericardial sac due to pericarditis
The sound occur with each heart cycle

20. Tinkling sound:
This sound heard in the cardiac area, indicate the presence of gas
on the surface of fluid enclosed in the pericardial sac.
The sound will be as fluid-
splashing “washing machine”.
Muffled sound:
This sound occur due to an increase in the volume of pericardial
fluid (pericardial effusion)

21. Heart rate
The heart
rate is
determined
by counting
the number
of beats per 1
minute .
Animal Range
Horse, adult 28 – 46
Foal 60 – 100
Cattle, adult 60 – 80
Calf (up to 1
year)
80 – 100
Sheep, Goat 70 – 90
Dog, small
breeds
90 – 120
Dog, large
breeds
65 – 90
Cat 110 – 130
Camel 25 - 50

22. Abnormal heart rate:
Tachycardia: it is a marked increase in
the heart rate,
Bradycardia: it is a marked slowing of
heartbeat
Heart rhythm
The normal rhythm of the heartbeat
is in three-time and described as
( LUBB-DUPP-pause ).

23. Heart intensity
The intensity or “loudness” of
the heart sounds depends on
1-The strength of the heartbeat
2-The thickness of the thoracic
wall,
3-The presence of any factor which
interferes with or enhances the
transmission of the sounds from
the heart to the stethoscope

24. Examination of jugular vein
Jugular vein present in subcutaneous in the
jugular furrow on both side of neck
Examination of the jugular vein provides a
valuable indication of the functioning of the right
side of the heart. Examination include ….
A-Jugular pulsation:
Several events in the cardiac cycle cause
pulsation in the jugular vein.
It may be physiological (Half of neck)
or pathological (Full neck)

25. Normal or negative jugular pulsation “Physiological jugular pulsation”:
It occurs during the early part of systolic phase of the cardiac cycle when
the blood being temporarily unable to enter the contracting right
atrium ,its dammed back in the jugular vein

27. True, or positive jugular pulsation “Pathological jugular pulsation”:
It is consists of typical pressure wave, run forward from the thoracic
inlet to the angle of mandible.
It occurs during cardiac systole in the case of the tricuspid incompetence
because the blood in the right ventricle is regurgitated back through
incompletely closed valvular orifice into the right atrium and jugular vein.

28. False jugular pulsation:
It is associated with transmission of the pulse from the underlying
carotid artery through the jugular vein.
It is noted in sever emaciated animals and can be easily differentiated
from true jugular pulsation by occluding the jugular vein with the thumb,
if the pulsations continue then they are associated with a transmitted
carotid pulse

29. B- Jugular engorgement or Venous stasis
Negative Jugular engorgement
If the vein is compressed digitally in the middle of the neck it
becomes distended above the pressure point because of the
accumulation of blood,whereas the section below the pressure point
will become empty

30. positive Jugular engorgement
When the jugular vein is become visibly distended from upper and
lower part after compressed digitally (Venous stasis )
Its occur in right-sided congestive heart failure, pericarditis,
endocarditis, and myocarditis,

31. Examination of capillaries
Sclera is the best place to examine the peripheral capillaries.
The capillaries on the sclera may
be normal “contain enough quantity of venous blood”,
or abnormal as follows….

32. Engorged:
when the sclera appeared redden and the capillaries filled and
corrugated with blood.
Empty:
when the sclera appeared pale or whitish and the capillaries empty from
blood.
Capillary refilling time:
Capillary refilling time is examined through oral mucous
membrane(Gingiva) (Gum) . It is a useful indicator of perfusion of
peripheral tissues and the state of the cardiovascular system
Normal refilling time of capillaries is 1-2 second