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Jill's Quizzes > Cardio Medicine > Flashcards

Cardio Medicine Flashcards

(68 cards)

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1
Q

Define heart failure

A

When the heart is unable to maintain adequate cardiac output to supply the body with adequate circulation

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2
Q

What is the most common canine cardiac disease?

A

Endocardiosis

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3
Q

What breeds are more commonly associated with canine cardiomyopathy?

A

Large of giant breed dogs

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4
Q

What are some of the general clinical signs of heart failure?

A

Tachycardia, coughing, exercise intolerance, anorexia, cachexia, cyanosis etc.

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5
Q

What valve does chronic valvular heart disease normally affect?

A

Mitral > Mitral and tricuspid

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6
Q

Describe the pathophysiology of chronic valvular heart disease in dogs

A

The valvular lesions grow and lead to insufficiency and therefore regurgitation of the blood from the ventricle into the atrium.
This gradually progresses over many years until we see degeneration .
Regurgitation (and volume overload) leads to the walls of the atria stretching and remodeling,
Enlarged chambers cause the valve leaflets not being able to meet properly, which makes the leak worse
Aortic output suffers
The atrium and the veins draining into it are unable to stretch any more. The left side lymphatic drainage is unable to clear the fluid and pulmonary oedema results -CHF

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7
Q

What is the consequence of a ruptured chordae tendinae?

A

Pulmonary oedema within 10 mins

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8
Q

What is the consequence of a Atrial tear?

A

Right sided heart failure also

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9
Q

What are the three factors that determine arterial pressure?

A

HR, peripheral resistance and stroke volume

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10
Q

What is the first heart sound associated with?

A

Closure of the AV valves (mitral and tricuspid)

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11
Q

What is the second heart sound associated with?

A

Closure of the pulmonic and aortic valves

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12
Q

What causes a mumur?

A

Turbulent blood flow within the heart

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13
Q

What are innocent mumurs?

A

Haemic or physiologic cause and not associated with a defect e.g. Puppy blood with lowered haematocrit

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14
Q

How should you describe murmurs?

A

Location, loudness and when

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15
Q

What are some DDx of CVHD? (Chronic valvular heart disease)

A

Respiratory disease, infective endocarditis, sick sinus syndrome, late-presenting congenital disease

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16
Q

What do you do if you hear a mumur in a happy, healthy dog?

A

Maybe nothing! If there is no other abnormalities ? do survey radiographs, arterial blood pressure measurement and baseline blood work (PCV, TPP, Creatinine). And if all clear ? client education, routine health maintenance and checkups, avoiding high salt food,

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17
Q

How would you treat a dog with mild to moderate CVHD?

A

Exercise restriction, frusemide, ACEI (enalapril), pimobendan and eventually spiranolactone, MAYBE digoxin. DO not give frusemide on its own, give with ACEI

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18
Q

What do you need to check when changing dose or starting medication of ACEI?s?

A

Check that the drug has not increased serum creatinine substantially

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19
Q

How would you treat a dog with severe acute CVHD?

A

Supplement O2, cage rest, IV frusemide, oral pimobendan, dopamine

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20
Q

When is prognosis poor for a dog with CVHD?

A

If advanced, non-responsive or severe, or an acute exacerbation of a chronic stable case

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21
Q

In bacterial endocarditis, describe some of the consequences of septic emboli

A

Kidney infarction

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22
Q

In bacterial endocarditis, describe some of the consequences of Ag-Ab immune complex formations

A

Protein losing nephropathy, inflammation of joints

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23
Q

What is the cause of infectious endocarditis?

A

Most commonly bacteria strep, staph etc.

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24
Q

Describe the pathogenesis of infectious endocarditis

A

Mitral and aortic valves most commonly affected. Leaflets ulcerate, platelets adhere to collagen, fibrin deposition, enlargement, vegetations form and this provide great protection for the nasty bacteria

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25
What are the clinical features of infectious endocarditis?
Fever, new/changing heart mumur, history of a dirty procedure,
26
How do you diagnose infectious endocarditis?
Diastolic mumur at the heart base is suggestive. Echocardiograph. Two or more positive blood cultures.
27
How do you collect a blood culture sample?
Needs to be a sterile venepuncture, collect a large volume (10ml), n different veins, an hour apart for each,
28
How do you treat infectious endocarditis?
Aggressive bacteriocidal therapy capable of penetrating fibrin. Eg beta-lactam and amino glycoside.
29
Describe canine cardiomyopathies
Are a primamry cardiac muscle disease that results in poor contractility and CHF. Lareg to giant breed dogs get dilated CMO
30
Describe the pathophysiology of canine cardiomyopathies
Decreased contractility leads to systolic dysfunction. Atrial fibrillation often develops in dogs with DCM especially irish wolfhounds and ventricular tachyarrythmias develop.
31
What are some of the clinical features of CCM?
Normally dogs 4-10 yrs old, exercise intolerance, weakness, lethary, weight loss, cardiac cachexia
32
How do you diagnose CCM? (canine cardiomyopathies)
Signalment, history, systolic mitral or tricuspid mumur, irregular/irregular sounds, signs of congestive heart failure
33
How may you treat CCM in the overt stage?
ACEI, spiranolactone, beta blockers and antiarrythmic drugs, COMPLETE EXERCISE RESTRICTION, frusemide, pimobendan, digoxin,
34
What is the prognosis for a dog with CCM? (canine cardiomyopathies)
Guarded to poor, up to 3 months survival after CHF diagnosis
35
What are some examples of secondary CCM?
Doxorubicin, toxins, poisonous plants etc.
36
What is the number one cardiac disease of cats?
Cardiomyopathies more specifically hypertrophic
37
What is the cause of feline HCM?
Idiopathic, strong genetic predisposition in some breeds ie main coon
38
Describe the pathophysiology of HCM in cats
Thickening of of LV wall and septum, diastolic dysfunction due to stiff walls. Pregressively a large LA, pulmonary congestion, thrombus formation in LA or LV. Additionally there may be LV outflow obstruction, myocardial ishaemia and mitral insufficiency, biventricular failure and pleural effusion.
39
What are the clinical feature of HCM in cats?
Most common in middle aged,male cats. May be asymptomatic -? aortic thromboembolism or panting with mild exertion. Disease may seem acute but actually has been developing for a decent amount of time, maybe pulmonary crackles or maybe muffling
40
How do you diagnose HCM?
History and clinical exam, echocardiography and always rule out secondary causes eg hyperparathyroidism etc.
41
What are the three main cardiac congenital anomalies?
PDA, pulmonary stenosis and subaortic stenosis
42
What congenital defects can cause volume overload?
AV dysplasia, septal defect
43
What congenital defects can cause pressure overload?
Sub-valvular stenosis: pulmonic or aortic
44
How do you diagnose congenital cardiac defects?
Majorly signalment and echocardiography
45
What is the most common congenital CV defect?
Patent ductus arteriosus
46
What does a PDA sound like on auscultation?
Machinery or train
47
What type of shunting occurs with PDA?
L to R or R to L
48
Why do hyperkinetic pulses occur in PDA patients?
Overcirculation
49
How do you diagnose PDA?
Clinical exam: mumur and hyperkinetic pulses. Radiography: left side heart ?knuckles?, echocardiography
50
What is the treatment of L ? R shunting PDA?s?
Surgery as early as possible as 50% of patient die before 1 yr. Ligation/catheter based occlusion
51
What is the treatment of R ? L shunting PDA?s?
No surgery anymore, possible phlebotomy, enforced rest, stress avoidance
52
What are the main sites for sub-aortic stenosis (most common ? least common)?
Subvalvular > valvular > supravalvular
53
Describe the pathophysiology of sub-aortic stenosis
Subvalvlar fibrous ring, LV pressure overload, concentric hypertrophy, inadequate coronary perfusion, worsening outflow tract
54
What is the history of most sub-aortic stenosis?
Exercise intolerance, syncope, sudden death, left sided heart failure
55
How do you diagnose sub-aortic stenosis?
Radiography: left ventricular enlargement, aortic bulge in DV, ECG, exercise induced arrhythmia, echocardiography for definitive Dx ? Manage with B1 blocker (atenolol)
56
What dogs does pulmonic stenosis more commonly occur in?
English bulldogs M>F.
57
What are the clinical findings with pulmonic stenosis?
Often asymptomatic, poor exercise tolerance, syncope. Systolic ejection mumur, +/- jugular pulse, +/- arrhythmias.
58
How do you diagnose pulmonic stenosis?
Echocardiography. Will see right ventricular enlargement on radiograph
59
How do you treat pulmonic stenosis?
Balloon dilatation, exercise restriction, treatment for CHF
60
What are the clinical findings of ventricular septal defect?
Auscultation there is harsh, holosytolic murmur on right side, radiography: left side enlargement, right side ventricle enlargement, echocardiography for definitive Dx.
61
What are the clinical findings of atrial septal defect?
Auscaltation: splitting of S2, +/- systolic or diastolic mumur, radiography is right-sided cardiac enlargement, echocardiography for definitive DDx
62
What four things make the tetralogy of fallot?
Pulmonic stenosis, dextraposition of the aorta, ventricular septal defect, secondary right ventricular hypertrophy
63
What will you see on clinical examination of a tetralogy of fallot?
May be tolerated for years, exercise intolerance, syncope. Cyanosis, mumur, erythrocytosis
64
How do you treat tetralogy of fallot?
Phlebotomy, enforce rest and avoid stress
65
What is mitral dysplasia?
Common congenital disorder in cats.
66
Describe how you would perform pericardiocentesis
Palpate the point of maximum cardiac impulse, clip, prep and lignocaine. Make extra holes in you catheter if necessary. Make a small nick in the skin and advance over-the-needle catheter with extension set and large syringe attached. Gently apply negative pressure. As you advance you may get some pleural fluid (keep it). Once advanced far enough you will enter ther pericardial sac where the fluid is dark red/haemorrhagic. Drain using three way tap and a 60ml syringe.
67
What are reactive mesothelial cells
Normal cells that may be obtained during pericardiocentesis
68
What is the commonest cardiac tumor?
Haemangiosarcoma

Jill's Quizzes (4 decks)

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