Canine Flash Notes - Cardiology Review Flashcards by Madeleine Swindell

what are some examples of valvular diseases in dogs?

endocardiosis, congenital aortic stenosis, congenital pulmonic stenosis, congenital av valve dysplasia, bacterial endocarditis, av valvular regurgitation due to cardiomegaly

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what is S1?

heart sound one, lub - closure of the AV valves (start of ventricular systole)

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what is S2?

second heart sound, dub - closure of semilunar valves (aortic & pulmonic valves) start of ventricular diastole

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what is the most common cause of a split S2 sound?

heartworm disease - due to delayed closure of a semilunar (aortic or pulmonic) valve

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T/F: S2 may be absent in arrhythmias if the ventricles do not fill adequately (semi lunar valves don’t open)

true

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what is the difference between the stenosis & regurgitation?

stenosis - obstruction of flow, usually congenital

regurgitation (insufficiency) - incomplete closure of valve, either congenital or acquired

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what is the purpose of the left & right av valves?

prevent back flow of blood into the atria during ventricular systole

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what is the purpose of the pulmonic & aortic semi-lunar valves?

prevent back flow of blood into ventricles during ventricular diastole

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what is the hallmark of valvular disease in dogs?

murmurs - due to turbulent blood flow over the valve

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T/F: severity of disease & severity of murmur are not correlated but progression of a murmur does indicate a progression of disease

true

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what are some examples of causes of low grade murmurs with no other signs of cardiac disease?

anemia, fever, anxiety, kittens/puppies under 6 months old, hypoproteinemia, & athletic heart

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what are some murmurs that should be worked up with ECG, rads, & echo?

murmur with clinical signs of cardiac disease

continuous or diastolic murmur

gallop rhythm

pulse deficits

progression of murmur

murmur when anesthesia is contemplated due to increased risk (grades 2-6, check for cardiac disease)

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what are the different grades of murmurs?

1 - very soft, minutes to hear in a quiet room

2 - soft murmur but definite

3 - moderate

4 - loud, no precordial thrill

5 - loud with palpable precordial thrill

6 - loud, precordial thrill & heard with the stethoscope off of the chest wall

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what are examples of pathologic systolic murmurs? diastolic murmurs? continuous murmur?

overall - stenosis, regurgitation, & shunts

systolic - left av valve regurgitation, aortic stenosis, pulmonic stenosis, right av valve regurgitation, & VSD

diastolic - aortic valve regurgitation

continuous - PDA

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T/F: atrial septal defects, pulmonic regurgitation, & tetralogy of fallot are rare causes of murmurs

true

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what are radiographic findings seen with right atrial enlargement?

lateral view - elevation of trachea at carina, loss of cranial waist

DV view - 9 to 11 o’clock bukge

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what are radiographic findings seen with left atrial enlargement?

lateral - elevated trachea & carina, separation of mainstem bronchi (left above right)

DV view - 2 to 3 o’clock bulge (auricle), cowboy legs (spread mainstem bronchi)

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what are radiographic findings seen with right ventricular enlargement?

lateral - 6 to 9 o’clock bulge, more sternal contact, trachea & carina elevation, & apex elevated off of sternum

DV view - 6 to 9 o’clock bulge (backwards or reverse D) & apex shifted more to the left

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what are radiographic findings seen with left ventricular enlargement?

lateral - loss of caudal waist, 3 to 6 o’clock bulge

DV view - rounding at 3 to 5 o’clock & apex shifted right

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what are causes of an enlarged aortic arch seen on rads? what is seen?

PDA, aortic stenosis, & aortic aneurysm

lateral - elongated cardiac silhouette, protrusion of cranial heart border at 11 to 1 o’clock

DV view - widened aortic arch at 11 to 1 o’clock

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what are causes of an enlarged MPA seen on rads? what is seen?

pulmonic stenosis, HWD, PDA, septal defects with left to right shunting (VSD, ASD)

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what is the main cause of pulmonary edema in dogs?

usually caused by left sided congestive heart failure - fluids back up into the pulmonic circulation

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what are the 2 types of pulmonary edema? how are they differentiated on rads?

interstitial edema - fluid in lung tissue, vessels are fuzzy but evident, more opaque lung field (linear or nodular, greater in perihilar area) & air still evident in lungs

alveolar edema - alveoli are filled with fluid, opaque lung field, no air in lungs, air bronchograms, & no vasculature seen

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what are the radiographic findings of overcirculation? what are some of the main causes? what are the differentials you should consider?

arteries larger than veins & more opaque lungs

HWD, PDA, left to right shunts (VSD, ASD), CHF, & fluid overload

ddx - expiratory rad or underexposure

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what are the radiographic findings of undercirculation? what are some of the main causes? what are the differentials you should consider?

more radiolucent lungs, arteries smaller than veins causes - right to left shunt, pulmonic stenosis, hypovolemic shock, adrenal insufficiency ddx - emphysema, over-inflation, & overexposure

what are the main differentials to consider for pleural effusions?

hydrothorax, ascites, right sided CHF, right av tricuspid regurgitation, pulmonic stenosis, HWD, pericardial effusion/pericarditis, tetralogy of fallot, uremia, hypoproteinemia, & fluid overload other pleural effusions - pyothorax, hemothorax, chylothorax, neoplasia, & pleuritis

what are the main cardiac differentials to consider for pulmonary edema?

cardiogenic edema with visible cardiomegaly - left sided CHF, chronic MVD, cardiomyopathy, ruptured chordae tendinae cardiogenic edema without cardiomegaly - electrical shock, trauma, cardiomyopathy in some cases, tachyarrhythmia, & myocardial depressants

what are some causes of non-cardiogenic pulmonary edema?

infection, toxin, allergy, drowning event, venous obstruction, hypoalbuminemia

what are some causes of increased tissue density often mistaken for pulmonary edema?

interstitial fibrosis, interstitial pneumonia, atelectasis, allergic conditions, & lungworms

what is seen on radiographs in a dog with pleural effusion?

lat - increased opacity in ventral thorax & scalloped appearance due to fluid in tissues DV view - retraction of lungs from thoracic wall, blunting of costophrenic angles, widening of mediastinum, scalloped appearance, & blurring/disappearance of cardiac silhouette

if you see ascites & hepatomegaly in an animal on rads, what do you suspect?

right sided heart failure - fluid back up into the body (systemic veins)

what is m-mode for echos? what is it used for? what does it requires?

ice pick images of the heart that gives lines for ventricles, left atria, aorta, valves requires viewing movement of the heart over time uses - measures cardiac wall thickness, chamber size, cardiac contractility (fractional shortening), & valves in motion

what is the purpose of using doppler on a cardiac ultrasound?

compares the frequency of transmitted ultrasound with received US of moving cells (blood cells), cells moving towards the transducer have a higher frequency than those moving away used to estimate velocity of blood flow

what does a p-wave indicate on an ecg?

atrial depolarization

what does the p-r interval indicate on an ecg?

delay of impulse through AV node & bundle of his

what does the qrs complex indicate on an ecg?

ventricular depolarization

what does a q-wave indicate on an ecg?

depolarization of septum

what does a r-wave indicate on an ecg?

depolarization of left ventricle

what does a s-wave indicate on an ecg?

depolarization of right ventricle

what does a s-t segment indicate on an ecg?

interval of ventricular systole

what does a q-t segment indicate on an ecg?

ventricular depolarization & repolarization

what does a t-wave indicate on an ecg?

repolarization of ventricles

what are the goals in heart failure management?

1. maintain or increase cardiac output 2. minimize myocardial oxygen demand 3. reduce activity & anxiety 4. relieve fluid accumulation (edema) 5. control rhythm disturbances

what are examples of bradycardic arrhythmias?

sinus bradycardia, atrial/sinoatrial standstill, sick sinus syndrome, 1st degree av block, 2nd degree av block, 3rd degree av block, junctional rhythm, & branch blocks

what are examples of tachycardic arrhythmias?

atrial tachycardia, atrial fibrillation, junctional tachycardia, ventricular tachycardia, ventricular fibrillation, & cardiac arrest

what treatment is used for heart disease & heart failure?

rest + O2 + diuretics + digoxin + anti-arrhythmics

what medication should not be given to animals with HCM? what do you give them instead?

digoxin - not a contractility problem diltiazem - cause relaxation to increase ventricular filling

what are some surgical heart diseases?

PDA, PPDH, PS, & large septal defects

what are some ecg findings from animals with congenital cardiac defects?

atrial enlargement - big p wave left ventricular enlargement - tall wave right ventricular hypertrophy - right axis deviation widened QRS

what are the most common congenital cardiac defects in dogs & cats?

dogs - PDA cats - av valvular dysplasia