Auscultation and Physical Diagnosis

Chapter 142 Auscultation and Physical Diagnosis

Physical examination follows the obtaining of a complete history and the consideration of the species, age, breed, and sex (see Chapter 1). Diagnosis, or at the very least a number of plausible diagnoses, may be made in many instances by history and signalment; however, following a thorough physical examination, a single, “most likely” diagnosis can be made with reasonable assurance in most patients with cardiac problems.

Physical examination is best performed in a systematic manner, initially conducting those portions that are least likely to aggravate or to cause discomfort to the patient. Physical examination of the cardiovascular system can be separated into four steps: inspection, palpation, percussion, and auscultation. What separates the physical examination from the remainder of the cardiac examination is the close relationship between the veterinarian and the patient, and, with the exception of the stethoscope, the absence of elaborate instrumentation such as radiography, electrocardiography, or echocardiography.


Inspect the patient while obtaining the history. Perform the inspection while the animal enters the room; while the pet stands, sits, or walks; while the owner supports the pet; and while the pet stands alone.

Mucous Membrane Color

Pattern of Ventilation

Observing the pattern of ventilation is extremely important. Characterize the rate and depth of breathing, and identify dyspnea.

Jugular Vein Evaluation

Analysis of the jugular vein (Fig. 142-1) is simpler if the hair is clipped from around the jugular furrow or if it is moistened with 70% alcohol. Look for pulsations in the vein and estimate the pressure distending it.

A firm, distended jugular vein that collapses briefly immediately after the second heart sound is consistent with cardiac tamponade from pericardial disease. (see Chapter 151) Causes in dogs include hemorrhage into the pericardial sac due to a bleeding neoplasm or rupture of the left atrium with severe mitral regurgitation. Constrictive pericarditis and chronic respiratory disease also can cause similar jugular venous changes.

Aug 27, 2016 | Posted by in SMALL ANIMAL | Comments Off on Auscultation and Physical Diagnosis

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