History and Physical Examination

In evaluating the cardiac patient, a complete and thorough history, and physical examination are essential. The observations made during the history and physical examination will guide all diagnostics throughout the patient's care. The medical history should start with the presenting complaint or the reason the client felt the need to bring the animal to the veterinary cardiologist. In patients that present with a history or clinical signs indicative of cardiovascular disease, the physical examination is an irreplaceable tool in the diagnostic process. This chapter presents the physical examination from head to tail, focusing on the indicators of cardiovascular disease. It then focuses on auscultation and abdominal palpation. The technique of auscultation of the thorax is as old as recorded medicine, as far back as Hippocrates. Murmurs are the most common abnormal heart sound reported and can imply serious cardiac abnormalities. Abdominal palpation may reveal signs of right-sided congestive heart failure (CHF).