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Cardio - Congenital Diseases Flashcards

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1
Q

How is a grade I murmur described?

A

Soft murmur heard in only 1 valve location, only in very quiet room, may only be intermittent

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2
Q

How is a grade II murmur described?

A

Soft murmur heard consistently, but only in 1 valve area

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3
Q

How is a grade III murmur described?

A

Moderate murmur heard in multiple valve locations on one side of the chest

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4
Q

How is a grade IV murmur described?

A

Loud murmur heard on both sides of the chest

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5
Q

How is a grade V murmur described?

A

Loud murmur heard at all valve locations associated with precordial thrill

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6
Q

How is a grade VI murmur described?

A

Loud murmur heard at all valve locations, even with stethoscope held 1 cm from chest wall

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7
Q

What are the locations for describing murmurs?

A

L apical, L basilar, R apical, parasternal

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8
Q

What are the timing categories for murmurs?

A

Systolic, diastolic, continous, to-and-fro

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9
Q

What are ways to describe the quality of a murmur?

A

Regurgitant (plateau), ejection (crescendo-decrescendo), machinery, decrescendo

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10
Q

What are “innocent” puppy/kitten murmurs?

A

physiologic murmurs without structural heart disease

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11
Q

Why are physiologic murmurs common in puppies and kittens?

A

They have larger SV than adults –> turbulence in Ao/PA

Thinner chest walls

Higher SNS tone

Anemia (lower blood viscosity)

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12
Q

What are characteristics of innocent murmurs?

A

Soft (grade I-III), L-sided, early or mid-systolic, disappear by 4-6 months

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13
Q

What are the most common congenital heart diseases in puppies?

A

PDA, PS, SAS

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14
Q

What is a PDA?

A

patent ductus arteriosus;

Failure of closure of ductus arteriosus (descending Ao –> MPA)

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15
Q

What are the consequences of a PDA?

A

L-R shunt –> LV volume overload –> L-CHF

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16
Q

What is the signalment for PDA?

A

Poodle, Sheltie, Pomeranian, Cocker, Maltese, Yorkie, GSD

Female > male

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17
Q

What kind of murmur is heard with PDA?

A

Continuous “washing machine” murmur at L heart base

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18
Q

What is the prognosis of PDA with and without treatment?

A

With = normal life

Without = POOR

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19
Q

What are the 2 types of treatment for PDA?

A

Interventional catheterization (ACDO)

Surgical ligation (thoracotomy)

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20
Q

What is PS?

A

Pulmonic Stenosis:

Congenital narrowing/thickening of the pulmonic valve

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21
Q

What are the consequences of PS?

A

RV pressure overload –> R-CHF, syncope, arrhythmias

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22
Q

What is the signalment for PS?

A

Smaller breeds (3 Bs: Boxer, Beagle, Bulldog), Chihuahua, Schnauzer

Male = female

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23
Q

What murmur type is heard with PS?

A

Systolic ejection murmur at the L heart base

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24
Q

What is the prognosis of PS?

Study These Flashcards
A

Depends on severity;

Mild = normal lifespan

Severe = guarded with no treatment, good with balloon valvuloplasty

25
What are the treatment options for PS?
Mild/moderate = atenolol Severe = balloon valvuloplasty
26
When should you refer a systolic L-sided murmur to a cardiologist?
If it is LOUD (grade IV or higher); If it is soft, recheck and refer if still present \>6 months
27
What is SAS?
Subaortic Stenosis Congenital ridge/narrowing below aortic valve
28
What is unique about SAS?
The lesion continues to pregress throughout growth
29
What are the consequences of SAS?
LV pressure overload --\> LVH --\> syncope, arrhythmias, sudden death, L-CHF, endocarditis
30
What is the signalment for SAS?
Large breeds (Newife, Boxer, GSD, Gonden, Rottie) Male = female
31
What type of murmur is heard with SAS?
Systolic ejection murmur at L heart base
32
What is the prognosis for SAS?
Depends on severity: Mild = normal lifespan without tx Severe = ~5 years (bimodal)
33
What is the treatment for SAS?
Atenolol if mod/severe; **No good procedure** - balloon valvuloplasty NOT effective This is not a valve that you can just pop open like in PS
34
How long do echoes need to be rechecked in SAS?
Continue rechecking as an adult as the disease progresses until dog is fully grown
35
What are other congenital heart diseases in dogs?
VSD - R sided murmur Tricuspid valve dysplasia - Labs, R-sided murmur Cyanotic heart defects (R to L shunting) - tetralogy of Fallot, reversed VSD/PDA
36
When should you refer a puppy with a murmur?
Any continous, diastolic, or R-sided murmur L-sided murmur if you can hear it on both sides Any murmur still heard after 6 months
37
What are the most common congenital heart diseases in kittens?
VSD, AV valve dysplasia
38
\_\_\_\_\_ murmurs are more common in cats than dogs, even as adults.
physiologic
39
Why are there fewer surgical/interventional options for congenital diseases in cats?
They are small
40
\_\_\_\_\_ heart disease is still a reasonable differential for cats \<1 yr
acquired
41
What is a VSD?
Ventricular Septal Defect: Abnormal communication between LV and RV
42
What are consequences of VSDs?
L-R shunting --\> LV volume overload --\> L-CHF
43
What type of murmur is seen with VSDs?
Systolic plateau or decrescendo murmur @ R side
44
What is the prognosis for a small/restrictive VSD?
Normal lifespan with no treatment (LOUD murmur!)
45
What is the prognosis for a large/nonrestrictive murmur?
L-CHF (softer murmur)
46
What size VSD is more common?
small/restrictive
47
What is the treatment for a small VSD?
none
48
What is the treatment for a large VSD?
Treat CHF when it occurs; No corrective procedure in cats (can attempt surgery or device closure in dogs)
49
What is mitral and tricuspid valve dysplasia?
Abnormal development and leakage/stenosis of mitral and/or tricuspid valves
50
What are the consequences of MV/TV dysplasia?
LV or RV volume overload --\> R- or L-CHF
51
What murmur is heard with MV/TV dysplasia?
Systolic plateau/regurg murmur @ L or R apex
52
What is the prognosis of MV/TV dysplasia?
Depends on degree of dysplasia/regurg/stenosis
53
What is the treatment for valve dysplasia?
Treat CHF when it occurs, no corrective procedure available
54
When should you refer a kitten with a murmur?
Same rules as dogs, but there are fewer surgical/interventional options for cats
55
What age has innocent murmurs?
\<4 months
56
What is the intensity of an innocent murmur?
I-II, maybe III
57
What is the timing of an innocent murmur?
systolic
58
What is the location of an innocent murmur?
L side

Small Animal Medicine (100 decks)

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