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Cardiology > Clinical examination of the cardiovascular system > Flashcards

Clinical examination of the cardiovascular system Flashcards

1
Q

Breed disposition of mitral valve disease

A

CKCS

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2
Q

Breed disposition of cardiomyopathy

A

Dobermans

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3
Q

Breed disposition of aortic stenosis

A

Boxers

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4
Q

Cause of syncope/lethargy

A

Reduced cerebral perfusion

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5
Q

Cause of weakness/reduced stamina

A

Reduced skeletal muscle perfusion

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6
Q

Cardiac causes of a cough

A

Mitral valve insufficiency with left atrial enlargement and compression of the left main-stem bronchus

Often in the abscence of heart failures

Softer and moister than resp cough

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7
Q

Cardiac dyspnoea/wheeze/orthopnoea

A

Due to pulmonary oedema or pleural effusion

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8
Q

Possible physical exam findings in heart failure

A

Slow capillary refill time

Pale or cyanosed MM, dry/tacky MM

Jugular venous distension

‘Resp’ signs

Thrill on precordial palpation

Hepatomegaly and/or splenomegaly

Abdominal effusion/ascites

Subcut oedema

Pulse deficits

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9
Q

What are pulse deficits?

A

Pulse deficits are present when the pulse rate is less than the heart rate.

This occurs because a cardiac contraction or several contractions take place prematurely not allowing enough time for ventricular filling (preload).

This results in heart beats that do not eject enough blood to generate a palpable pulse.

The presence of pulse deficits should alert you to the occurrence of premature ectopic beats.

These may be either supraventricular or ventricular in origin, only the ECG can distinguish these.

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10
Q

What is a hepato-jugular reflux?

A

This test checks for the presence of jugular distention or jugular pulsations when pressure is placed in the region of the cranial abdomen in a ventral to dorsal direction.

The animal should be standing or in sternal recumbency to perform this test.

A positive test result indicates that there is elevated pressure in the right atrium or right ventricle.

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11
Q

What does a positive heapto-jugular reflux test show?

A

Indicates that there is elevated pressure in the right atrium or right ventricle.

If one were to classify an elevated pressure in the right heart as mild, moderate or severe; venous distention indicates a severe elevation in pressure, a positive HJR indicates a moderate elevation in pressure.

Patients with a mild elevation in pressure to the right heart cannot be identified on physical examination.

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12
Q

How to determine strength of the pulse:

A

Pulse pressure = systolic pressure - diastolic pressure

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13
Q

What is the arterial pulse affected by?

A

Left ventricular stroke volume

Ejection velocity

The relative compliance and capacity of the arterial system

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14
Q

When do exuberant (bounding) arterial pulses occur

A

Patent ductus arteriosus and aortic valve insufficiency

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15
Q

Palpation of the heart

A

Palpate the precordial impulse – left side 4th –5th intercostal space

Feel for a precordial thrill – caused by vibrations created by turbulence within the heart through the chest wall

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16
Q

What can be identified on heart auscultation?

A

heart murmurs

gallop rhythms

dysrhythmias

count heart rate - tachycardia/bradycardia

muffled heart sounds due to pleural or pericardial effusions

17
Q

Diaphragm of the stethoscope used for?

A

High frequency sounds

18
Q

Bell of stethoscope used to accentuate:

A

low-frequency sounds - 3rd and 4th heart sounds in dogs

19
Q

Where is the apex beat heard?

A

Over the mitral valve (left apex)

20
Q

Where are aortic and pulmonary valves heard?

A

Over left heart base

21
Q

Where can the precordial impulse be felt?

A

left side 4th - 5th intercostal space (left apex)

22
Q

What heart sounds are normally heard in cats and dogs?

A

S1 and S2

23
Q

What does S1 correlate to?

A

Closure of the AV valves - start of systole

Loudest at the apex of the heart

24
Q

What does S2 correlate to?

A

Closure of the semi-lunar valves

Marks the end of systole and beginning of diastole

Loudest at heart base

25
Q

S3 in small animals

A

Abnormal heart sound

Coincides witht the opening of the mitral valve

Heard in heart diseases that cause dilation of the ventricles (DCM)

Caused by vibrations in a stiffer than normal left ventricular wall

26
Q

S4 in small animals

A

Atrial contraction and flow through the AV valve

Most commonly heard in cats with HCM where ventricle is over-distended

27
Q

What is a gallop rhythm?

A

The presence of S3 or S4

28
Q

Split S1 sound

A

can be heard in some normal large-breed dogs.

29
Q

Split S2 sound

A

Occurs when there is asynchronous closure of the semi-lunar valves e.g. when pulmonary hypertension causes delayed closure of the pulmonic valve.

30
Q

Two mechanisms of heart murmurs

A

Turbulence of blood flow

Vibration of a cardiac structure

31
Q

How does blood viscosity affect a heart murmur?

A

If the viscosity of blood is decreased –> murmur;

If the viscosity of blood is increased –> mask a murmur.

32
Q

Characteristics of functional physiologic murmurs

A

soft low amplitude sounds

occur early in systole

PMI over the left base

tend to vary in intensity with a change in HR or body position

33
Q

Aetiology of functional (physiologic) murmurs

A

common in young animals

common in athletes

occur in pathologic states as fever, anaemia

hypoproteinaemia

34
Q

Grade I murmur

A

can only be heard after auscultation in a quiet room, unilateral

35
Q

Grade II murmur

A

can be heard bilaterally, more easily than I

36
Q

Grade III murmur

A

same intensity as the heart sounds

37
Q

Grade IV murmur

A

louder than the heart sounds, no precordial thrill

38
Q

Grade V murmur

A

louder than the heart sounds, but with a thrill

39
Q

Grade VI murmur

A

can be heard with the stethoscope lifted away from the chest wall

Cardiology (10 decks)

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