Cardiovascular Disease Flashcards
(124 cards)
1
Q
What is diastole?
A
The state of the cardiac cycle where the ventricles are relaxed and filling
2
Q
What is systole?
A
The state of the cardiac cycle where the ventricles are contracting
3
Q
What is the normal heart rate for a dog?
A
60-180 bpm
4
Q
What is the normal heart rate for a cat?
A
120-240 bpm
5
Q
What is a congenital heart disease?
A
A disease which is present from birth
6
Q
What are some examples of congenital cardiac disease?
A
Aortic or pulmonic stenosis
Patent ductus arteriosus
Ventricular septal defect
7
Q
What is aortic/pulmonic stenosis?
A
Narrowing of the aortic/pulmonic valves
8
Q
What are acquired heart diseases?
A
Diseases which present in adult animals
9
Q
What are some examples of acquired heart disease in dogs?
A
Dilated cardiomyopathy
Pericardial effusion
Myxomatous mitral valve disease
10
Q
What is a common acquired heart disease in cats?
A
Hypertrophic cardiomyopathy
11
Q
What are the 2 main types of cardiac arrhythmias?
A
Bradyarrhythmia
Tachyarrhythmia
12
Q
What methods can be used to diagnose heart disease?
A
History and physical examination Blood tests Blood pressure ECG (+/- Holter monitor) Echocardiography Thoracic radiographs
13
Q
What is a Holter monitor?
A
24hr ECG
14
Q
What are the typical presentations for cardiac disease?
A
Incidental finding Exercise intolerance and weakness Syncopal episodes Difficulty breathing Sudden death
15
Q
What specific presentation often results from right-sided heart disease?
A
Distended abdomen
16
Q
Which factors are important to heck during a physical examination for suspected CV disease?
A
Body condition Respiratory rate Mucous membranes and CRT Jugular vein Peripheral pulses
17
Q
What is cardiac cachexia?
A
Loss of lean muscle mass despite good appetite in dogs with CV disease
18
Q
What could be the cause of distended jugular vein?
A
Right-sided heart disease
19
Q
What is the normal respiratory rate for a dog?
A
<30 brpm (sleeping)
20
Q
What happens to the respiratory rate in animals with chronic heart failure?
A
Increases >35-40 breaths per minute
21
Q
What should you be checking for during heart auscultation?
A
Heart rate
Rhythm
Assess pulses simultaneously
Presence of heart murmurs
22
Q
Why is it important to check the peripheral pulses alongside heart beat?
A
Assess pulse quality and pulse deficits
23
Q
What are pulse deficits?
A
Where there is a heart beat heard but no pulse felt
24
Q
What is a precordial thrill?
A
A very loud heart murmur
25
What is important to check for when auscultating the lungs?
Respiratory rate
Adventitious sounds
Crackles
26
What are the typical clinical cardiovascular findings when an animal has heart failure?
```
Reduced cardiac output
Weak peripheral pulses
Tachycardia
Pale MM, prolonged CRT
Heart murmur
Arrhythmias
Gallop sounds
```
27
In what type of heart diseases are gallop sounds more commonly heard?
Myocardial diseases
28
What are the typical findings with left-sided heart congestion?
Pulmonary oedema
Tachypnoea and dyspnoea
Cough
29
What are the typical findings with right-sided heart congestion?
Distended peripheral veins
Ascites
Pleural effusion
30
What type of blood testing is used for diagnosing CV disease?
Haematology
Biochemistry
Cardiac biomarkers
31
Why is haematology used in diagnosing CV disease?
Checking for systemic diseases
| Anaemia
32
What is a haemic murmur?
A 'whooshing' sound on auscultation because anaemic blood passes through the heart faster
33
Why is biochemistry used in diagnosing CV disease?
Assessing kidney values
| Monitoring electrolytes
34
Which cardiac biomarkers are used when testing for heart disease?
Cardiac troponin I (marker for myocardial cell damage)
| NT-proBNP (marker for myocardial stretch)
35
What is the normal systolic BP in a dog?
120-140mmHg
36
Why should you measure blood pressure at the same level as the heart?
To give the most accurate measurement
37
What effect does hypertension have?
Increases cardiac workload
| Can contribute to progression of disease
38
What effect does hypotension have?
Might indicate decompensated heart failure
39
How low does blood pressure need to be to be a concern?
<80mmHg
40
Why might you use ECG?
To further characterise auscultatory findings (bradycardia, tachycardia, irregular rhythm, pulse deficits)
41
What are the benefits of using a Holter monitor?
Can investigate intermittent arrhythmias (frequency, severity)
Monitoring response to antiarrhythmic therapy
42
Why might you use echocardiography?
To diagnose cardiac disease (plus severity and prognosis)
Monitor progression of disease
Assess treatment options and monitor response to treatment
43
What are thoracic radiographs indicated for?
Cough
Tachypnoea
Dyspnoea
44
How many views are needed when taking thoracic radiographs?
At least 2 - right lateral and dorsoventral
45
What is cardiomegaly?
An enlarged heart (seen on x-ray)
46
How is heart size measured on thoracic radiographs?
Using vertebral heart size
47
What is the normal vertebral heart size for dogs and cats?
Dogs <10.7
| Cats <8
48
Aside from vertebral heart size, what other signs of cardiomegaly can be seen on a radiograph?
Elevation of trachea
| Increased sternal contact
49
In what locations can a stenosis form?
Subvalvular
Valvular
Supravalvular
50
How is stenosis of the great vessels diagnosed?
Echocardiography
51
Where does an aortic stenosis usually form?
Subvalvular
52
What can an aortic stenosis lead to?
Left ventricular hypertrophy
| Left-sided congestive heart failure
53
Where does a pulmonic stenosis usually form?
Valvular
54
What can a pulmonic stenosis lead to?
Right ventricular hypertrophy
| Right-sided congestive heart failure
55
What are the clinical signs and findings for stenosis of the great vessels?
```
Arrhythmias
Exercise intolerance
Syncope
Congestive heart failure
(Sometimes asymptomatic)
```
56
What are the treatment options for stenosis of the great vessels?
Beta blockers
Balloon valvuloplasty (pulmonic)
Standard treatment for congestive heart failure
57
What is the effect of beta blockers in the treatment of stenosis?
Reduces the amount of work the ventricles have to do
58
What is the ductus arteriosus?
Normal fetal connection between pulmonary artery and aorta
59
What does the ductus arteriosus close to form?
Ligamentum arteriosum (when take first breaths)
60
What happens as a result of a patent ductus arteriosus after birth?
Blood flows from aorta to pulmonary artery
61
What does a patent ductus arteriosus sound like on auscultation?
Loud continuous murmur at the level of the left heart base
62
What is the treatment for a patent ductus arteriosus?
Interventional closure
Surgical ligation
Congestive heart failure therapy
63
What is a ventricular septal defect?
A hole in the ventricular septum
64
What are the symptoms of ventricular septal defect?
Usually asymptomatic - most diagnosed defects are small
65
Where is the most common location for a ventricular septal defect?
Upper septum, just below aortic valve
66
How loud is a MILD right-sided systolic murmur (with ventricular septal defect)?
Loud murmur
67
How loud is a SEVERE right-sided systolic murmur (with ventricular septal defect)?
Soft murmur
68
How is a ventricular septal defect diagnosed?
Echocardiography
69
How is a ventricular septal defect treated?
Usually none necessary
| Heart failure treatment if needed
70
What is the life expectancy for an animal with a ventricular septal defect?
Normal (if small defect)
71
What causes myxomatous mitral valve disease?
It is idiopathic
72
What breed/age are more likely to develop myxomatous valve disease?
```
Small breeds (cavaliers, dachsunds)
Adult onset (7+ years)
```
73
Which valves are affected in myxomatous mitral valve disease?
Mitral and tricuspid
74
How is myxomatous mitral valve disease diagnosed?
Echocardiography
75
What happens to the valves in myxomatous mitral valve disease?
Thickening of the valve leaflets
| Prolapse of valve leaflets into the atrium
76
What happens to blood flow/heart structure as a result of myxomatous mitral valve disease?
Regurgitation of blood back into the atrium
| Left atrial and ventricular dilation
77
How quickly does myxomatous mitral valve disease progress?
Slow progression
| Long asymptomatic period, murmur may be incidental finding
78
What type of murmur does myxomatous mitral valve disease cause?
Left-sided apical systolic murmur
79
What can myxomatous mitral valve disease progress into if left untreated?
Left-sided congestive heart failure
80
What causes dilated cardiomyopathy?
It is idiopathic
81
What breeds/age are more likely to suffer from dilated cardiomyopathy?
Large breed dogs (doberman, great dane, newfoundland)
| Adult onset
82
What type of murmur does dilated cardiomyopathy cause?
Left apical systolic murmur
83
What changes in the heart does dilated cardiomyopathy cause?
Left ventricular dilation
Decreased systolic function
Arrythmias
84
How is dilated cardiomyopathy diagnosed?
Echocardiography
85
What animals are more likely to suffer from pericardial effusion?
Large breed adult dogs
86
What are the common causes of pericardial effusion?
Idiopathic, neoplasia
87
What effect does pericardial effusion have on the heart function?
Fluid in the sac around the heart compromises filling
Decreased cardiac output
Right-sided heart failure (collapses under pressure)
88
How is pericardial effusion diagnosed?
Echocardiography
89
How is pericardial effusion treated?
Pericardiocentesis
90
How is pericardiocentesis carried out?
Mild sedation, left lateral recumbency
3rd-8th intercostal space
Large catheter
Echocardiography used to find best spot
91
How can you check efficacy of pericardiocentesis?
Check fluid for clotting/PCV
Measure volume drained
Collect samples for cytology and culture
92
What causes hypertrophic cardiomyopathy?
Genetic causes
93
What effect does hypertrophic cardiomyopathy have on heart function?
Increased myocardial thickness impairs filling in diastole
94
How is hypertrophic cardiomyopathy diagnosed?
Echocardiography
95
What does hypertrophic cardiomyopathy sound like on auscultation?
Heart murmur
| Gallop sound
96
Which factors in-clinic can precipitate heart failure?
stress
anaesthesia
fluid therapy
97
What are the signs of aortic thromboembolism (caused by hypertrophic cardiomyopathy)?
Sudden onset lameness
Cold leg
Peripheral cyanosis
Pain
98
What can heart failure be due to?
Disease progression
Decompensation of previously stable heart failure
Development of impedance of cardiac filling
99
What is left-sided heart failure?
Congestion of pulmonary circulation - pulmonary oedema
100
What are the signs of left sided heart failure?
Tachypnoea
Dyspnoea
Pulmonary crackles
Cough (not always)
101
What is right-sided heart failure?
Congestion of the systemic circulation
102
What are the signs of right-sided heart failure?
Distended peripheral veins
Positive hepatojugular reflux
Ascites
Pleural effusion
103
What is the result of left AND right sided heart failure?
| How does it present?
Decreased cardiac output
Presents as tachycardia, weak peripheral pulses, slow CRT
104
How might cats with heart failure present?
Hypothermia and bradycardia
105
What are the possible treatments for heart failure?
Furosemide (diuretic)
Minimise stress
Oxygen
Pimobendan
ACE inhibitor
Spironolactone
Water always available
106
What is the main goal of heart failure treatment?
Reduce the circulating volume of blood
107
Why must water always be available to patients undergoing heart failure treatment?
Avoiding acute kidney injury
108
What are the target parameters when monitoring patients with heart failure?
<40 breaths per min
>100mmHg
Decreased HR
Improved pulse quality and CRT
109
What does this ECG trace show?
Normal rhythm
110
What are the different types of bradycardia?
Sinus bradycardia
Atrial standstill
AV blocks
Sick sinus syndrome
111
How does 2nd degree AV block appear on an ECG?
As non-conducted P waves
112
What does this ECG trace show?
2nd degree AV block
113
How does 3rd degree AV block appear on an ECG?
As wide and bizarre QRS complexes
114
What does this ECG trace show?
3rd degree AV block
115
Where does supraventricular tachycardia originate?
From the atria
116
How does supraventricular tachycardia appear on an ECG trace?
QRS complexes are narrow
117
What does this ECG trace show?
Supraventricular tachycardia
118
How does atrial fibrillation appear on an ECG trace?
200+ bpm
| Irregular rhythm with no P waves
119
What does this ECG trace show?
Atrial fibrillation
120
Where does ventricular arrhythmia originate?
From the ventricular myocardium
121
How does ventricular arrhythmia appear on an ECG trace?
As wide and bizarre QRS complexes
122
What is shown on this ECG trace?
Ventricular arrhythmia
123
What is shown on this ECG trace?
Ventricular premature complexes
124
What is shown on this ECG trace?
Ventricular tachycardia (HR 375bpm)
