cardiology

Question 1

CHF C/S

Answer 1

dyspnea (resp distress)
hx of heart murmurs
lung crackles, tachycardia
exercise intolerance, cough

Question 2

CHF dx

Answer 2

POCUS- B lines, La:Ao >2:1
rads- alveolar/interstitial pattern (perihilar in dogs, diffuse in cats), enlarged LA, pulmonary vein congestion

Question 3

MVD

Answer 3

acquired degeneration of left AV valve-> mitral regurg-> enlarged LA

sm breeds, left sided apex murmur

Question 4

MVD dx

Answer 4

early- murmur only-> progression, cough
chamber enlargement-> CHF

high BNP (non specific)
echo gold standard-> can see valves, contractility

TXR- LA enlargement

tx if La:Ao >1.6:1, VHS >10.5

Question 5

MVD tx

Answer 5

stage A, B1: none
yearly- 6m exam, rads, echo

B2: pimobendan 0.25-0.3mg/kg q12
consider adding ACEi
recheck q3-6m

C: CHF

Question 6

stage C (CHF) tx

Answer 6

after stabilization:
low sodium diet
furosemide 2mg/kg q12
pimobendan 0.25-0.3mg/kg q12
ACEi 0.5mg/kg q12-24

recheck-> 1wk, 1m, 3m (check kidneys)

Question 7

recurrent CHF tx

Answer 7

increase furosemide to q8, add spironolactone
increase pimo to q8
increase ACEi to q12

Question 8

cardio renal syndrome

Answer 8

monitor renal values
decreased perfusion-> decreased kidney function-> sodium/water retention

Question 9

pulmonary arterial hypertension

Answer 9

secondary to lower airway disease
causes syncope, exercise intolerance, cough

dx- enlarged RA/RV, large pulmonary artery, echo

tx viagra

Question 10

DCM

Answer 10

acquired myocardial disease
grain free diets, lg breed dogs

C/S- cough, exercise intolerance, murmur/arrhythmia (afib), pulse deficits, syncope

Question 11

DCM dx

Answer 11

Ecg not sensitive, rads look normal ant first-> rounded heart w edema in CHF

echo- gold standard
BNP

Question 12

DCM tx

Answer 12

ACEi and pimo to slow progression

CHF-> regular tx + sotalol, mexiletine for ventricular arrhythmias

Question 13

HCM

Answer 13

LV concentric hypertrophy-> LA dilation-> CHF

no C/S until CHF (sometimes gallop), leads to FATE

Question 14

HCM dx, tx

Answer 14

TXR- valentine shaped heart, diffuse edema, pleural effusion

echo
check TT4

tx: tx in B2, add ACei

Question 15

cat CHF tx

Answer 15

furosemide 1-2mg/kg q12
beta blockers- atenolol 6.25mg q12-24
ACEi 0.25-0.5mg/kg q24
clopidogrel 18.75mg q24

Question 16

ARVC

Answer 16

arrhythmogenic RV cardiomyopathy-> ventricular arrhythmia, syncope, sudden death

dx- holter monitor (everything else can look normal)

tx- sotalol, mexiletine for VPCs