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These findings should be taken into consideration during clinical use of these measurements, especially if a patient is being monitored for cardiac changes over time via serial radiographs." RETURN TO TOP Manubrium Heart Score (MHS) In a February 2017 article, researchers proposed assessing cardiac enlargement based upon comparing the length of the dog's manubrium (the handle-shaped, broad upper part of the sternum, from which the clavicles and first ribs extend)