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Patient Care 2 > Circulatory system disease > Flashcards

Circulatory system disease Flashcards

1
Q

What is congenital heart disease?

A
  • Disease present at birth
  • Breed specific
  • Usually detected in first health check
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2
Q

What are the clinical signs of congenital heart disease?

A
  • Poor growth
  • Exercise intolerance
  • Lethargy
  • Dyspnoea
  • Coughing
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3
Q

How may congenital heart disease be diagnosed?

A
  • Obtain clinical history
  • Clinical examination
  • Thoracic x-rays
  • ECG
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4
Q

What is patent ductus arteriosus (PDA)?

A
  • Most common congenital defect in dogs
  • In the fetus a vessel (ductus arterioles) connects the pulmonary artery to the aorta
  • If this fails to close at birth the lungs become overloaded
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5
Q

What are the clinical signs of PDA?

A
  • Loud heart murmur (owner can sometimes hear/feel)
  • Poor growth
  • Asymptomatic or in heart failure
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6
Q

What is the treatment for PDA and its prognosis?

A
  • Surgical closure of the vessel (easy fix)
  • Implantation of a coil
  • Excellent prognosis
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7
Q

What is aortic and pulmonary stenosis?

A
  • Narrowing of the aortic or pulmonary valves
  • Blood flow leaving the ventricles is obstructed
  • Heart muscle needs to work harder
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8
Q

What are the clinical signs of aortic and pulmonic stenosis?

A
  • Heart murmur
  • Fainting
  • Heart failure
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9
Q

What is the treatment and prognosis for aortic and pulmonic stenosis?

A
  • Dilation of the area using balloon (easy fix)

- Prognosis varies but tends to be good

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10
Q

What is mitral and tricuspid valve dysplasia?

A
  • Valves are malformed and therefore displaced
  • Blood regurgitates into the atria
  • Workload increases and they enlarge leading to congestion
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11
Q

What are the clinical signs and treatment for mitral and tricuspid valve dysplasia?

A

Clinical signs:

  • Heart murmur
  • Heart failure (type dependent on which valve affected)

Treatment:
-Same as heart failure

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12
Q

What is ventricular/atrial septal defects?

A
  • ‘Holes in the heart’ connecting with either the atria or ventricles
  • Blood flows through the heart abnormally
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13
Q

What are the clinical signs, treatment and prognosis of ventricular/atrial septal defects?

A

Clinical signs:

  • Heart murmur
  • Asymptomatic or congestive heart failure

Treatment:

  • Surgery to correct defect
  • Same as heart failure

Prognosis:
-Good to guarded

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14
Q

What is an overriding aorta?

A
  • A congenital heart defect
  • Aorta is positioned over the ventricular septal defect instead of over the left ventricle
  • Resulting in the aorta containing some blood from the right ventricle, which reduces the amount of O2 in the blood
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15
Q

What is a persistent right aortic arch?

A
  • A vascular ring anomaly
  • Malformation of the major arteries of the heart
  • Traps the oesophagus
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16
Q

What are the clinical signs of a persistent right aortic arch?

A
  • Regurgitation of food (solid food rather than puppies on a liquid diet)
  • Aspirational pneumonia
  • “Poor doer”
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17
Q

What is the treatment and prognosis of persistent right aortic arch?

A

Treatment:

  • Surgery to ligate and cut remnant
  • Feeding from a height or liquid food

Prognosis:
-Usually good if haven’t aspirated

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18
Q

What is tetralogy of Fallot?

A
  • Uncommon
  • Some patients can present with a combination of defects:
  • > Ventricular septal defect
  • > Pulmonic stenosis
  • > Compensatory right-sided hypertrophy
  • > Overriding aorta
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19
Q

What clinical signs and prognosis is seen with tetralogy of Fallot?

A

Clinical signs:

  • Cyanosis
  • Hypoxic
  • Collapse

Prognosis:
-Guarded (hard to fix)

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20
Q

What is portosystemic shunt?

A
  • Abnormal single or multiple blood vessels which directly join the blood supply from the intestines to the main circulation (no breakdown of urea)
  • Toxic blood then circulates the body (including the brain)
  • Ammonia passes around the body
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21
Q

What are the clinical signs for portosystemic shunt?

A
  • Stunted growth
  • Poor muscle development
  • Disorientation
  • Circling/head pressing
  • Seizures
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22
Q

What are the nursing management and care implications necessary for portosystemic shunt?

A

-Emergency nursing care (IVFT, enema to remove intestinal toxins before they are absorbed, anti-convulsant drugs eg. diazepam)
-Diet change (reduce amount of protein and feed only high quality, high digestible protein diets)
-Lactulose (decreases absorption of ammonia/other toxins and makes the intestinal environment unfavourable for toxin-producing bacteria)
Antibiotics (Alter the bacteria; population in the intestines and to reduce intestinal bacterial overgrowth)
-Ameroid constrictor (band placed over shunt during surgery to slowly close the shunt)
-Anti-seizure medication

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23
Q

What is hemangiosarcoma?

A
  • Malignant tumour derived from the cells lining blood vessels
  • Common in spleen and heart base
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24
Q

What are the clinical signs for hemangiosarcoma?

A
  • Depression
  • Lethargy
  • Refusal to walk
  • Pale MM
  • Dyspnoea
  • Distended abdomen
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25
Q

What are the nursing care implications and treatment for Hemangiosarcoma?

A

Nursing care:

  • Close monitoring for improvement/deterioration of clinical signs
  • Support throughout surgery
  • Close monitoring post surgery

Treatment:

  • Blood transfusion
  • Surgical removal of spleen
  • Chemotherapy
  • Prognosis poor
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26
Q

What is endocardiosis?

A
  • Progressive condition
  • Mitral valve most commonly affected (also tricuspid valve)
  • Commonly due to fibrosis which affects function of valves
  • Blood regurgitates into the atria increasing workload
  • Causes congestion and heart failure
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27
Q

What are the clinical signs, diagnostics and treatment of endocardiosis?

A

Clinical signs:

  • Heart murmur
  • Left/right sided heart failure

Diagnostics:

  • History
  • Thoracic radiographs
  • ECC & ECG
  • Blood culture

Treatment:

  • Same as heart failure
  • Broad spectrum AB’s following blood culture results (Endocarditis)
28
Q

What is myocardial disease?

A
  • Diseases associated with cardiac function

- More common in cats than dogs

29
Q

What is hypertrophic cardiomyopathy (HCM)?

A
  • Thickening of heart muscle interferes with relaxation of the heart
  • Normal filling of heart is prevented
  • Poor diastolic function
  • Decreased cardiac output
  • Heart failure
30
Q

What are the clinical signs of HCM?

A
  • Silent
  • Dyspnoea
  • Tachypnoea
  • Tachycardia
  • Heart murmur
31
Q

What are the clinical signs of HCM with an aortic thromboembolism complication?

A
  • Acute onset of uni/bilateral paresis/paralysis of the hindlimbs
  • Lack of arterial pulse in the affected leg(s)
  • Hindlimb(s) cold, pads pale and quiks blue
  • Pain
  • Dyspnoea/tachypnoea
32
Q

What diagnostics and treatment is performed for HCM?

A

Diagnostics:

  • ECC & ECG
  • Thoracic x-rays
  • Blood tests and pressure management (eg. clotting profiles)
  • Abdominal USS

Treatment:

  • Cardiac relaxation and slowing heart rate
  • Pain relief (VITAL - methadyne)
  • Antithrombotics and vasodilators
33
Q

What is dilated cardiomyopathy?

A
  • Dilation of the heart chambers
  • Enlargement of the heart
  • Poor systolic function
  • Congestions and heart failure
34
Q

What are the clinical signs of dilated cardiomyopathy?

A
  • Anorexia/weight loss
  • Reduced exercise intolerance/lethargy
  • Ascites (do USS)
  • Heart murmur, arrhythmias, atrial fibrillation
  • Usually left sided heart failure, sometimes right
  • Sudden death
  • Common in giant breeds (eg. GSD, Labrador, Great Dane)
35
Q

What are the diagnostics and treatment performed for dilated cardiomyopathy?

A

Diagnostics:

  • ECC & ECG
  • Thoracic radiographs

Treatment:

  • Individual assessment
  • Same as heart failure
36
Q

What are arrhythmias?

A
  • Disturbance of electrical activity within the heart
  • Possibly due to primary heart disease
  • Possibly secondary to another systemic disease
  • Broadly categorised
37
Q

What are the clinical signs, diagnostics and treatments for arrhythmias?

A

Clinical signs:

  • Asymptomatic
  • Exercise intolerance/weakness
  • Collapse

Diagnostics:

  • Blood tests
  • ECC & ECG
  • Thoracic x-rays

Treatment:

  • Antiarrhythmic
  • Pacemaker
38
Q

What is pericardial effusion?

A
  • Effusion accumulates in the pericardial sacs
  • Restricts filling of the right side of the heart
  • Right-sided heart failure
39
Q

What are the clinical signs of pericardial effusion?

A
  • Pale MMs
  • Muffled heart sounds
  • Tachycardia
  • Variable pulse quality
  • Distended abdomen
  • Exercise intolerance/collapse
40
Q

What are the diagnostics and treatment of pericardial effusion?

A

Diagnostics:

  • ECG
  • Thoracic radiographs

Treatment:

  • Relieving pressure around the heart
  • Fluid removal and analysis
  • IVFT
  • Tends to reoccur
41
Q

What are the clinical signs of acute heart failure?

A
  • Reluctance to exercise/collapse
  • Pale MMs
  • Cyanosis
  • Slow CRT
  • Weak pulse and quality
  • Heart murmur
  • Cough/dyspnoea/tachypnoea
42
Q

What are the treatments and nursing care implications for acute heart failure?

A

Treatment:

  • Medical therapy (thoracocentesis, diuretic, other under VS direction)
  • Furosemide (diuretic), no fluids but leave water

Nursing care:

  • Cage rest
  • Do not stress
  • Provide O2
  • Monitor RR and vital signs
43
Q

What are the clinical signs of left-sided heart failure?

A
  • Reluctance to exercise/fatigue/lethargy
  • Pale MMs
  • Cyanosis
  • Heart murmur
  • Tachycardia
  • Dysrhythmias
  • Cough/dyspnoea/tachypnoea
44
Q

What are the clinical signs for right-sided heart failure?

A
  • Ascites
  • Abdominal distention
  • Hepatomegaly/splenomegaly
  • Reluctance to exercise/fatigue/lethargy
  • Pale MMs
  • Cyanosis
  • Heart murmur
  • Tachycardia/dysrhythmias
  • Dyspnoea/tachypnoea
45
Q

What are the treatments and nursing care for left/right-sided heart failure

A

Treatment:
-Medical therapy (diuretics, anti-arrhymics, other under VS direction)

Nursing care:

  • Reduce exercise
  • Reduce obesity (if applicable)
  • Low salt diet
  • O2
  • Keep warm
  • Monitor RR and vital signs
46
Q

What are the nursing care for chronic heart failure cases?

A
  • Decrease stress and exercise
  • Weight loss management
  • Monitor vital signs
  • Blood tests (dehydration and electrolytes imbalances)
  • Palatable diets

Prognosis poor depending on owner compliance

47
Q

Myocarditis

A

Inflammation of the muscular walls of the heart (rare)

48
Q

Endocarditis

A

inflammation of the endocardium, most commonly involving the heart valve

49
Q

Pericardia

A

Inflammation of the pericardium (sac around the heart)

50
Q

Cardiomyopathy

A

Primary disease of the heart muscle

51
Q

Cardiac tamponade

A

Compression of the heart due to fluid accumulation in the pericardial sac (emergency)

52
Q

Define shock

A

A state of acute circulatory collapse where the circulation is unable to transport sufficient oxygen to meet the tissue needs

53
Q

What are the main types of shock recognised?

A
  • Hypovolaemic
  • Distributive
  • Cardiogenic
  • Obstructive
54
Q

What clinical signs are seen with hypovolaemic shock?

A
  • Tachycardia
  • Slow CRT
  • Pale MMs
  • Poor pulse
  • Low blood pressure
  • Hypothermia
55
Q

What treatment and nursing care can be done for hypovolaemic shock?

A
  • Fluid replacement (electrolytes)
  • Arrest iof haemorrhage
  • O2 supply
  • Warmth and monitor glucose levels
  • Monitor urine output
  • Monitor lactate (2-2.5mm/s/litre - expect high lactate levels, if lactate not decreasing is poor prognosis)
56
Q

What is hypovolaemic shock?

A

Secondary to significant loss of circulatory fluid volume and is the most common

57
Q

What is distributive shock?

A

Generalised release of inflammatory mediators that promote vasodilation so the body is unable to control where blood volume is distributed
-Egs. Anaphylactic, toxic and septic shock

58
Q

What are the clinical signs off distributive shock?

A
  • Tachycardia
  • Poor pulse quality
  • Warm extremities
  • RED MMs
  • FAST CRT (both due to vasodilation)
59
Q

What treatment and nursing care can be done for distributive shock?

A
  • Underlying cause (antibiotics, antihistamines)
  • IVFT (electrolytes)
  • O2 supply
  • Warmth
  • Monitor urine output
  • Monitor lactate
60
Q

What is cardiogenic shock?

A

Condition where heart can no longer pump effectively, commonly seen in degenerative conditions of the heart muscle

61
Q

What are the clinical signs of cardiogenic shock?

A
  • Heart mururs
  • Irregular pulses (AV block)
  • Blue MMs
  • Diagnose with ECC, ECG and X-rays
62
Q

What treatment and nursing care can be done for cardiogenic shock?

A
  • Underlying cause
  • IVFT
  • O2 supply
  • Warmth
  • Monitor urine output and lactate
63
Q

What is obstructive shock and identify some examples

A

Associated with physical obstruction of large vessels or the heart (RARE)
-Egs. Pericardial effusion (fluid around heart), Pulmonary embolism, GDV

64
Q

Syncope

A

Temporary loss of consciousness caused by fall in blood pressure

  • Sudden
  • Reduction of O2 to the brain
65
Q

What are the levels of unconsciousness?

A
  1. Normal
  2. Depressed/obtunded (diminished awareness)
  3. Stupor (aware of surroundings but with some difficulty)
  4. Coma (all body functions are present but patient cannot be roused)
66
Q

What may cause syncope?

A
  • Bradycardia
  • Tachcardia
  • Reduced cardio output
  • Increase vagal tone (overstimulation causes blood vessels to dilate and blood pressure to drop)
  • Situational syncope (profound coughing, hard swallowing, vomiting or difficultly urinating and/or defecating
67
Q

What nursing care can be done for an unconscious patient?

A
  • Maintain the airway
  • Ensure patient conserves heat
  • Minimise shock
  • Confine to quiet, warm and dark kennel
  • Turn patient to avoid secondary complications
  • Assess levels of consciousness

Patient Care 2 (13 decks)

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