Differentiate systolic vs diastolic heart failure in dogs and list common supportive imaging findings.

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Systolic heart failure means the heart’s pumping ability is reduced because contractility is impaired, which lowers the stroke volume and ejection fraction. Diastolic heart failure means the ventricle is stiff and fills poorly during diastole, so filling pressures rise even though the overall pumping might be preserved. In dogs, this translates to distinct imaging patterns that help differentiate the two.

For systolic failure, echocardiography typically shows a dilated ventricle with reduced contractile function and a lower ejection fraction, reflecting the weaker forward pumping. Clinically, these dogs often exhibit weakness and exercise intolerance due to insufficient systemic perfusion. In diastolic failure, the ventricle may be stiff or thickened, leading to preserved or normal ejection fraction, but abnormal filling dynamics. Doppler and tissue Doppler findings reveal impaired relaxation and elevated filling pressures, and there may be hypertrophic remodeling with left atrial enlargement as a consequence of sustained high diastolic pressures.

Supportive imaging findings learned from practice include left atrial enlargement and signs of congestion on radiographs, along with echo patterns: reduced EF in systolic HF; normal or preserved EF with evidence of diastolic dysfunction in diastolic HF.