8. Cardiovascular Flashcards
(27 cards)
Aim of the examination of the cardiovascular system:
- To decide whether the cardiovascular system could cause the observed clinical signs?
- To decide whether a symptomless animal has any cardiac disease?
Order of examination (cardiovascular)
- History
- General condition (impression)
- Detailed examination of the cardiovascular system
Detailed examination of the cardiovascular system:
-Heart
- Blood vessels
• Arterial system
• Venous system
• Capillary system = mucous membranes
-Blood (mucous membranes, anaemia, polycytaemia, dehydration
What to look for in the history?
fatigue exercise intolerance dyspnea, tachypnea ascites syncope
Causes of dyspnea and/or tachypnea
- Pulmonary edema (e.g. left sided heart failure)
- Thoracic fluid accumulation (e.g. right sided heart failure, but in cats also due to left sided heart failure)
- Anaemia
- Respiratory disease, thoracic disease
- Metabolic causes
Normal breath/min:
- In clinic
- At home
- Sleeping at home
In clinic, at rest < 40/min
At home, at rest< 30/min
At home, sleeping< 25 /min
Can chronic cough without tachypnea and dyspnea be a cardiac disease?
Most probably not heart disease (excepts heart worm)
When can we see cough with piniksh foam?
In case of acute (fulminant) cardiac pulmonary edema animals may cough pinkish foam, emergency!!!!!!!!
Causes of Ascites:
- Right sided heart failure (mostly dogs)
- Hypoproteinaemia
- Peritonitis
- Neoplasma
- Liver cirrhosis
- Thrombosis
- Bleeding, etc. etc.
What does subcutaneous oedema indicate?
-Usually not due to heart failure in small animals
• Rarely in some large dogs together with ascites
• Localized or unilateral oedema never caused by heart failure
What is cardiac cachexia?
Animals with chronic, severe heart disease loose weight, they are not obese
Further examinations of the cardiovascular system: (the most important once)
- Thoracic radiography
- Echocardiography
- Electrocardiography (ECG)
- Blood pressure measurement
- Blood test (ANP, BNP, troponin, endothelin)
Further examinations of the cardiovascular system: (others)
– Phonocardiography (PCG) – Nonselective angiocardiography – Cardiac catheterization • intracardiac pressure measurement • oxymetry • selective angiocardiography – Radionuclide imaging – Serology (Lyme, ANA test, Dirofilaria, Trypanosome, etc.) – (CT, MRI)
Physical examinations of a cardiac patient:
- Inspection (heart, vessels)
- Palpation (heart, vessels)
- Percussion (heart)
- Auscultation (heart)
What do you inspect in the cardiac region?
-Abnormalities of the thorax (injury, malformation)
- Heart beat (ictus cordis) = apex beat in the dog and cat
– location (dislocation)
– intensity = strength (increased or decreased)
What do you palpate in the cardiac region?
(Detection of pain in the cardiac area)
- Location of the heart beat
- Strength
- Fremitus
Where should the heart be localized?
over the edge of the sternum
left side: 3-6 ICS,
right side: 3-5 ICS
what can dislocation of the cardiac beat be caused by?
tumor abscess pneumothorax diaphragmatic hernia, malformation
What can cause the strength (intensity) of the heart beat to increase?
exercise
cardiac hypertrophy,
dislocation
What can cause the strength (intensity) of the heart beat to decrease?
heart disease,
pericardial/pleural fluid,
thickened chest wall
Groups of fremitus?
endocardial, (pericardial, extrapericardial)
Endocardial = turbulent flow of the blood
In small animals primary goal of percussion of the thorax is to detect:
– Fluid accumulation
– Space occupying lesions
– PTX
Absolute dullness in dogs:
Left: 4-6 ICS
Right: 4-5 ICS
Relative dullness in cats:
usually not or difficult to detect
