Cardiology (key concepts only hopefully) Flashcards
(46 cards)
1
Q
Valsalva maneuver
A
- Put pressure on the vein and milk the one below
- The part that you milked should not refill
- If it fills back, there is an atrial problem
- If it refills in a pulsating way, issue is likely with the tricuspid valve
2
Q
Where does ventral edema typically show up?
A
- NOT IN THE LIMBS
- Under the chin
- Bottom of the abdomen
- Pectoral muscles
3
Q
Hyperkinetic pulses
A
- Aortic insufficiency
4
Q
Weak pulses
A
- Indicate poor cardiac contractility, ventricular filling or ejection
- Also seen in systemic conditions like hypovolemia, endotoxemia
5
Q
How to determine if a systolic murmur?
A
- If you feel the pulse when you hear the murmur, then it is systolic
6
Q
HR for an adult horse
A
-28-44 BPM
7
Q
HR for a newborn foal
A
80-120 BPM
8
Q
S1
A
- Closing of AV valves
9
Q
S2
A
- Closure of aortic and pulmonic valves
10
Q
S3
A
- Rapid ventricular filling
11
Q
S4
A
Atrial contraction (best heard on the left side)
12
Q
B-lub dup
A
4-1-2
13
Q
Lub drub
A
S1-S2-S3
14
Q
Make sure you can determine ECG leads
A
- do it
15
Q
Physiologic murmurs
A
- Common (fit horses, neonates, systemic disease)
- Systolic
16
Q
What is more common: regurgitation or stenosis?
A
- Regurgitation
17
Q
If you hear a diastolic murmur which valve is most likely affected?
A
- Aortic valve
18
Q
Aortic valve murmurs
A
- Heard during diastole
- Aging horse murmurs
- Often have bounding pulses
- Don’t have exercise intolerance
- Monitor with an echo once a month
19
Q
Mitral valve regurgitation
A
- Systolic on the left side
- Exercise intolerance
- Eventually goes to heart failure
20
Q
Tricuspid regurgitation
A
- On the right side
- Intensity does = severity on this one
- Can get a jugular pulse with this
21
Q
Ventricular septal defect
A
- Younger horses
- SYSTOLIC murmur (blood goes from left to right
22
Q
Patent ductus arteriosus
A
- Continuous murmur, loudest on the left side in a newborn foal
- Normal for 3-5 days
23
Q
What is the best test for evaluating a murmur?
A
- Echocardiography
24
Q
What is the best test for arrhythmia evaluation?
A
- ECG
25
Heart disease clinical signs
- Ventral edema
- Jugular pulse
- Peripheral vein distention
- Poor condition (Chronic)
- Small
- Growing slowly
26
Physiologic arrhythmias
- Common due to high vagal tone
- Not always present
- Disappear with exercise and excitement
27
2nd degree AV block
- Dropped beat
- Only hear the atrial contraction (would be S4)
- If you trot the horse, it will go away
- Usually due to high vagal tone
28
Pathologic arrhythmia causes
- Common
- Heart
- Metabolic disturbances (electrolyte disorders, colic, diarrhea, endotoxemia)
29
Atrial fibrillation ECG appearance
- f waves may be seen
- some QRS
- Missing p waves
30
Atrial fibrillation
- Most common arrhythmia
- Irregularly irregular
- Sounds like shoes in the drier
- Disorganized electrical signals
31
Clinical signs of atrial fibrillation
- Poor performance
- Unnoticed (if the horse isn't performing)
- May be diagnosed while doing a physical exam on a dental
32
Definitive diagnosis of AF
- ECG
| - Echocardiography (Atrial abnormalities)
33
Medical cardioconversion treatments for atrial fibrillation
- Quinidine gluconate (IV) - can be given if you KNOW FOR SURE that it has been there for less than 2 weeks
- Quinidine sulphate (NGT)
34
Quinidine sulphate cost and risks
- Very corrosive; will burn down the esophagus
- Can cause local irritation, colic, lethargy, anorexia, arrhythmias
- Cheap
- Can cause paraphemosis
- Edema in the nasal passage
- Give flunixin for pain
- Continuous monitoring
- Try five or 6 doses giving once every hour and reducing dose every time
35
Other attempt for treating atrial fibrillation
- Amiodarone (much more expensive)
| - May not be more effective
36
Atrial fibrillation prognosis
- If <3 months, prognosis is ~90-95% convert with 25% recurrence
- If >4 months, recurrence is higher
- If you have to do more than once, prognosis will worsen
37
Signs from increased right ventricular filling and systemic venous pressure
- Peripheral edema
- Vein distention
- Jugular pulse
(think of this as backwards failure)
38
Signs from heart dilatation and valve failure
- Decreased cardiac output
- Tachycardia
- Heart failure
(think of this as more forward failure)
39
Thrombophlebitis local irritation
- Extravascular injection
- Phenylbutazone is really bad
- Catheter
40
Thrombophlebitis associated with systemic disease
- Endotoxemia
| - DIC
41
Clinical signs of thrombophlebitis
- Hard and ropy vein
- Pain and heat
- Proximal edema
- Increased collateral damage
- Fever with lethargy and anorexia
- Local abscess or necrosis
42
What to do if your jugular catheter blows on one side?
- If it's healthy, put it on the other side
| - If it's sick, she will save the other side for euthanasia
43
Catheter sites*** (THIS IS PROBABLY THE QUESTION)
- if they have two jugulars you can put one on the other side
- Can use the lateral thoracic (point cranially)
- Can put it on the cephalic vein
44
Where can you NOT put a catheter in an adult horse? (AGAIN, likely associated with the question she would ask)
- Saphenous on the medial side of the back leg
45
Diagnosis of thrombophlebitis
- Can ultrasound
| - Always culture your catheter
46
Treatment of thrombophlebitis
- Flunixin
- Cold and hot packs to ease pain
- Topical NSAID
- Antibiotics
