Hi, just a quick question… What reference values do you usually use for M-mode?
I have a case who is panting and was scanned for ruling out cardiogenic origin.
Hi, just a quick question… What reference values do you usually use for M-mode?
I have a case who is panting and was scanned for ruling out cardiogenic origin.
Heart appears pretty normal to me both subjectively and on Mmode. However LVDd is on the higher end of my reference and I wonde how important it is if it 0.2mm bigger than the said reference range. I use Boon’s references from the last edition of the echocardiography book and I tried to figure out other references from the new edition of Nyland/matoon book and I struggle to find consistency… So… What references do you use??? Just curious.
I will post this case later but this is just to ask about your trusted refence sources:)
Thanks for any input.
( I hope it doesn’t mean I have to buy another book…);)
Comments
HI!
The appearance on right
HI!
The appearance on right sided 4-chamber views is much more important than reference values. My personal rules are:
1) in diastole, the left ventricular free wall fits 3.5-4.5 times into the left ventricular cavity
2) The IVS is straight
3) The interatrial septum is straigt,
4) The left atrium fits 2 times into the left ventricle
5) The right ventricular diameter is 1/3-1/2 of the left ventricualr diameter in diastole
6) The right free wall is 1/2 of the left free wall
7) On short axis, the LA is max 1.5 the aortic root
If you want to use reference values, I would not use June Boon’s but either
1) breed specific ones (sometimes difficult to find)
2) Cornell’s formula (I assume I will have to send one to sonopath to post it on the homepage)
If your subjective impression (see above) is that the heart looks normal, then there won’t be a hemodynamic problem, even if the dog has a heart murmur
Panting is almost never a sign of heart disease (as opposed to dyspnea or tachypnea)
If the ventricular diameter is 1mm larger than normal, this won’t cause clinical problems 🙂
i hope I could help!
best regards!
Peter
Hehehe. Yes Peter, it helps.
Hehehe. Yes Peter, it helps. I was hoping you would go online before USA:) thanks for that.
So, yes, I also belived that panting is usually not related to LCHF
. But I always think that I might be missing something. I follow your “scanning pearls” for subjective assessment.
So, may I ask why the measurements from Boon are not useful? And also… When are m-mode measurements relevant?
I would much appreciate if you post some guidance here on Sonopath:)
In this case I was confident enough to say panting is not cardiogenic and like you said… 2 mm more or less I don’t think are the difference for a failure or not… But… I’m not cardiologist:& so just wanted to check:) ( apologies, I cannot get rid of this last phrase!: and also I’m aware about the measurements
Hi!
Basically, all references
Hi!
Basically, all references have their limitations in terms of animals included, exclusion criteria and statistics. Some studies excluded animals with FS <30% (I see <30% frequently in healthy dogs..), dogs >12 yrs (I see them very frequently when they have DMVD…).
Cornell’s index has some limitations as well (some details of the measurements not mentioned etc.), still, it is currently the best reference for me, apart from breed specific papers.
I use M-Modes mostly for follow up comparisons or for breeding exams. I get the clinical information mostly from 2D-images rather than from measurements. An I record M-Modes for documentation. I don’t stick to references when I’m dealing e.g. with DMVD – > 2mm outside the normal range does not have a therapeutic consequence..
Also note: when you see e.g. volume overload, there must be a reason for this (e.g. valvular insufficiency, cardiomyopathy, shunt), This has to be taken into consideration as well.
best regards!
Peter
Thanks, Peter. This is very
Thanks, Peter. This is very helpful. I will investigate Cornwel index. Sorry, just last question, so, for breed specific information, other than the books I mentioned, where else do you search for this information? Thank you.
Hi!
Unfortunately, only
Hi!
Unfortunately, only primary literature…