Quiz: Calculate the Vertebral Heart Scale

Denaé Campanale, DVM, MPH, Cornell University Hospital for Animals

Amara Estrada, DVM, DACVIM (Cardiology), University of Florida

Cardiology|October 2018|Peer Reviewed|Web-Exclusive

Sign in to Print/View PDF

Vertebral heart scale (VHS) is an objective measurement of cardiac size on thoracic radiographs against recorded normal measurements to assess for cardiomegaly.

When used in combination with a thorough medical history and physical examination, VHS is useful for identifying possible heart disease and monitoring changes in heart size over time in a patient with diagnosed cardiac disease. In dogs with progressively increasing heart size, VHS has been demonstrated to correlate well with other methods of tracking cardiac changes, including echocardiography and ECG, and is considered a superior method by some.1

A lateral radiographic view should be assessed to calculate VHS. Patients can be positioned in right or left lateral recumbency; serial images should be taken on the same side.2 To calculate the VHS, the height of the heart should first be measured from the bottom of the left mainstem bronchus to the apex of the heart, using calipers. This measurement is represented by L in Figure 1. Then, the width of the heart should be measured at its widest point perpendicular to the first measurement. This measurement is represented by S in Figure 1

These two caliper measurements are then physically compared against the thoracic vertebrae. Starting at the cranial edge of the fourth thoracic vertebra, the caliper measurements of the heart should be matched against the vertebrae. The number of vertebrae that equal the distance of each measurement is represented by L and S. The sum of the 2 measurements (L + S) in vertebrae equals the VHS. For more information on measuring VHS, read our step-by-step guide here.

L is the height of the heart measured from the bottom of the left mainstem bronchus to the apex of the heart, while S is the width of the heart measured from its widest point perpendicular to the first measurement.
L is the height of the heart measured from the bottom of the left mainstem bronchus to the apex of the heart, while S is the width of the heart measured from its widest point perpendicular to the first measurement.

FIGURE 1 L is the height of the heart measured from the bottom of the left mainstem bronchus to the apex of the heart, while S is the width of the heart measured from its widest point perpendicular to the first measurement.

FIGURE 1 L is the height of the heart measured from the bottom of the left mainstem bronchus to the apex of the heart, while S is the width of the heart measured from its widest point perpendicular to the first measurement.

Table

Breed-Specific VHS Ranges*3-10

Breed VHS Normal Range
Beagle 9.9-10.7
Boxer 10.8-12.4
Bulldog (English and French) 11.0-14.4
Boston terrier 10.3-13.1
Cavalier King Charles spaniel 10.1-11.1
Dachshund 9.2-10.2
Greyhound 10.4-10.6
Labrador retriever 10.2-11.4
Pug 9.8-11.6
Pomeranian 9.6-11.4
Whippet 10.5-11.8
All other dog breeds 8.5-10.7
Cats 6.7-8.1

*An earlier version of this table originally appeared in the Clinician's Brief article Vertebral Heart Scale.

6  Questions
Multiple Choice Questions
Score 0/6

Quiz: Calculate the Vertebral Heart Scale

Take this quiz by answering the following multiple choice questions.
1/6  Questions
Score
Score 0/6
Clinician's Brief

Measured using this example diagram, what is the VHS of this heart?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
2/6  Questions
Score
Score 0/6
Clinician's Brief

Poppy, a 12-year-old spayed Chihuahua, is presented with radiographic images. Poppy’s owners recently moved to the area and want to obtain a second opinion regarding the “large heart” diagnosed by another veterinarian. 

What is Poppy’s VHS?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
3/6  Questions
Score
Score 0/6
Clinician's Brief

Wally, an 11-year-old neutered male Yorkshire terrier, is presented for recent development of lethargy and intermittent coughing. 

What is the VHS, and what is the best interpretation?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
4/6  Questions
Score
Score 0/6
Clinician's Brief

Audrey, a 6-month-old (recently) spayed dalmatian, is presented for cough, lethargy, and exercise intolerance. 

What is the VHS, and what is the best interpretation?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
5/6  Questions
Score
Score 0/6
Clinician's Brief

Warren, a 12-year-old neutered male crossbreed dog, was recently diagnosed with a mast cell tumor on his left pelvic limb. Radiographs are performed prior to anesthesia for the mass removal. 

What is the VHS, and what is the best interpretation?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
6/6  Questions
Score
Score 0/6
Clinician's Brief

Yoyo, a 2-year-old male ragdoll cat, is presented for severe respiratory distress. Every other cat from his litter has died in the last year. 

What is the VHS, and what is the best interpretation?

Select one of the above choices and click submit.
Quiz: Calculate the Vertebral Heart Scale
6/6  Questions
Multiple Choice Questions
Score 0/6

Quiz: Calculate the Vertebral Heart Scale

Final score
0 of 6

PACS = picture archiving and communication system, VHS = vertebral heart scale or score

References

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Practice Tools

Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2018 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Privacy Policy (Updated 05/08/2018) Terms of Use (Updated 05/08/2018)