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VET 408: Cardio/Respiratory > Congenital Heart Defects > Flashcards

Congenital Heart Defects Flashcards

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1
Q

congenital valve defects

A
  • sub aortic stenosis
  • pulmonary stenosis
  • mitral valve dysplasia
  • tricuspid valve dysplasia
  • cor triatriatum sinsiter/dexter
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2
Q

congenital shunt defects

A
  • PDA
  • VSD
  • ASD
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3
Q

what species/breeds are predisposed to sub aortic stenosis

A

large breed dogs (Goldens, Rottweilers, newfoundlands)

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4
Q

murmur for sub aortic stenosis

A

left basilar systolic ejection murmur

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5
Q

what is the primary lesion in sub aortic stenosis

A

ridge/ring underneath the aortic valve

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6
Q

what are secondary lesions in sub aortic stenosis

A
  • concentric hypertrophy of the LV from pressure overload
  • aortic insufficiency
  • post stenotic dilation of the aorta
  • AV endocarditis
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7
Q

what are signs of subaortic stenosis on echo

A
  • increased aortic outflow velocity
  • thick LV wall
  • fibrosis in LVFW
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8
Q

what treatment is there for sub aortic stenosis

A

B blockers (atenolol) to reduce load/demand on heart

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9
Q

what species/breed is predisposed to pulmonary stenosis

A

small breed dogs, brachycephalics

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10
Q

murmur for pulmonary stenosis

A

left basilar systolic ejection murmur

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11
Q

what is the primary lesion in pulmonary stenosis

A

fusion or thickening of the valve leaflets

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12
Q

what are secondary lesions in pulmonary stenosis

A
  • concentric hypertrophy of the RV from pressure overload
  • pulmonary insufficiency
  • post stenotic dilation of PA
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13
Q

what are signs of pulmonary stenosis on echo

A
  • increased pulmonary outflow velocity
  • RV wall thickening
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14
Q

what is the treatment for pulmonary stenosis

A

beta blockers (atenolol)
+
balloon valvuloplasty

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15
Q

what are the clinical differences between subaortic and pulmonary stenosis

A

SAS murmur has carotid radiation (can be heard in carotid sinuses), PS does not

SAS have weak/delayed pulses, PS has normal pulses

BREEDS
- large: SAS
- small: PS

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16
Q

what species/breeds are predisposed to mitral valve dysplasia

A

RARE in most species

dogs: bull mastiffs, bull terriers, labs
some cats

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17
Q

murmur for mitral valve dysplasia

A

left apical systolic regurgitant murmur

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18
Q

what is the primary lesion in mitral valve dysplasia

A

irregular valve architecture
OR
irregular chordae attachments

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19
Q

what are the secondary lesions in mitral valve dysplasia

A
  • eccentric hypertrophy of the LV from volume overload
  • LA dilation
  • mitral valve insufficiency
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20
Q

what are signs of mitral valve dysplasia on echo

A
  • LA and LV enlargement
  • papillary muscle anomalies
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21
Q

what is the treatment for mitral valve dysplasia

A

no fix - treat the CHF

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22
Q

what species/breed is predisposed to tricuspid valve dysplasia

A

labradors

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23
Q

murmur in tricuspid valve dysplasia

A

right apical systolic regurgitation murmur

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24
Q

what is the primary lesion in tricuspid valve dysplasia

A

irregular architecture
OR
irregular chordae attachments

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25
what secondary lesions are in tricuspid valve dysplasia
- eccentric hypertrophy of the RV from volume overload - tricuspid insufficiency - RA dilation
26
what are signs of tricuspid valve dysplasia on echo
- RA and RV enlargement - papillary muscle anomalies
27
what treatment is there for tricuspid valve dysplasia
no fix - treat the CHF
28
cor triatriatum sinister vs dexter
sinister: affects the LEFT atrium dexter: affects the RIGHT atrium
29
what species are predisposed to CT sinister vs dexter
sinister: cats dexter: dogs
30
what is the primary lesion in CT sinister/dexter
abnormal vessel entry into the atria sinister: pulmonary veins enter incorrectly into LA dexter: caudal vena cava enters incorrectly into RA
31
what is the treatment for CT sinister/dexter
balloon valvuloplasty and treat the CHF
32
what species are predisposed to PDA
dogs
33
murmur in PDA
left basilar continuous murmur
34
what is the primary lesion in PDA
incomplete ductal muscle causes failure of DA closure at birth causes blood to flow from aorta to PA
35
what are the secondary lesions in PDA
- eccentric hypertrophy of the LV from volume overload - pulmonary over circulation - aortic dilation, possibly PA dilation
36
what are signs of PDA on echo
- visualize the PDA - continuous flow from aorta to PA throughout systole and diastole - flow peaks velocity during systole
37
what kind of pulses are seen with PDA
hyper dynamic (bounding) due to low diastole pressure
38
what is the treatment for PDA
surgery - ductal occlusion
39
what species are predisposed to VSD
cats, horses, cows, camelids
40
restrictive vs nonrestrictive VSD
restrictive: very small opening between R and L ventricles nonrestrictive: large opening between R and L ventricles
41
murmurs in restrictive/nonrestrictive VSD
restrictive: very loud/harsh right sided murmur nonrestrictive: none; blood flow is too slow due to the equilibrium of pressures
42
what is the primary lesion in VSD
opening in between R and L ventricles causing blood to flow from LV to RV to pulmonary circulation back to LV
43
what are the secondary lesions in VSD
- eccentric hypertrophy of the LV from volume overload - pulmonary overcirculation
44
what are signs of VSD on echo
- color flow from LV to RV - high velocity flow if restrictive, low velocity if nonrestrictive
45
what is the treatment for VSD
restrictive: none, usually subclinical nonrestrictive: surgical closure if only involving muscular; or just treat CHF
46
what species/breeds are predisposed to ASD
dogs (standard poodles), horses, cows, camelids
47
murmur in ASD
left basilar systolic murmur **NOT diastolic even though shunt is during diastole because it is slow flow - the fast flow occurs on the L side during systole as the LV pushes out the larger volume
48
what is the primary lesion in ASD
opening between LA and RA flows from LA to RA to RV then through the lungs back to the LA LV never sees the increased load so even though its a L to R shunt, it causes R SIDED CHF
49
what are the secondary lesions in ASD
- eccentric hypertrophy of the RV from volume overload - pulmonary overcirculation - RA dilation
50
what treatment is used for ASD
none - usually asymptomatic
51
what defect causes a splintered QRS complex on ECG
tricuspid valve dysplasia
52
what defect causes a tall QRS and wide P wave on ECG
PDA
53
what defect causes a prominent Q wave on ECG
VSD
54
what is eisenmenger syndrome and which defects can cause it
chronic, unresolved L to R shunting defects can lead to pulmonary hypertension, causing R sided pressure to exceed L sided pressure, leading to shunt reversal
55
symptoms of eisenmenger syndrome
1. cyanosis - PDA: differential cyanosis of the caudal half - VSD/ASD: generalized cyanosis 2. polycythemia - deoxygenated blood reaching kidneys stimulates EPO production
56
tetralogy of fallot
combination of 4 heart defects: 1. pulmonary stenosis 2. VSD 3. overriding aorta 4. RV concentric hypertrophy
57
clinical signs of tetralogy of fallot
exercise intolerance, collapse, generalized cyanosis, R-CHF, polycythemia
58
what is the normal ventricular outflow velocity (both R and L)
<2 mm/s
59
what is the normal ventricular outflow pressure gradient
16 mmHg (4x2^2 = 16)
60
what is the pressure gradient during mild semilunar valve stenosis
25-50 mmHg
61
what is the pressure gradient during moderate semilunar valve stenosis
50-80 mmHg
62
what is the pressure gradient during severe semilunar valve stenosis
>80 mmHg

VET 408: Cardio/Respiratory (38 decks)

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