Congenital Part I

Question 1

how can we determine that an animal has congenital heart disease?

Answer 1

auscultation of murmur (most common)
remainder of cardiovascular exam
electrocardiogram
thoracic radiographs
echocardiography
cardiac catheterization

Question 2

what is the oxygen saturation in the pulmonary artery, right ventricle, and right atrium?

Answer 2

70%

Question 3

what is the oxygen saturation in the aorta, left ventricle, and left atrium?

Answer 3

98-99%
99% in left atrium

Question 4

who is predisposed to patent ductus arteriosus?

Answer 4

females
some breeds

Question 5

are most patent ductus arteriosi asymptomatic?

Answer 5

yes: just heart murmur points to diagnosis

Question 6

what can be found on the physical exam with a patent ductus arteriosus other than a murmur?

Answer 6

bounding arterial pulses
signs of CHF if it has developed
maybe arrhythmias- uncommon

Question 7

what can be seen on thoracic radiographs with a patent ductus arteriosus?

Answer 7

cardiomegaly
pulmonary overcirculation
three bumps

Question 8

what is surgical mortality in a thoracotomy to fix a patent ductus arteriosus?

Answer 8

2-5%

Question 9

what occludes the patent ductus arteriosus in intravascular coils?

Answer 9

thrombus forms to occlude in coils

Question 10

what can pulmonic stenosis be due to?

Answer 10

valvular stenosis
subvalvular stenosis
supravalvular stenosis

Question 11

what is pulmonary stenosis?

Answer 11

narrowed pulmonary outflow tract

Question 12

what happens with the pulmonary trunk with pulmonary stenosis?

Answer 12

post-stenotic dilation of pulmonary trunk

Question 13

what are the clinical signs of pulmonary stenosis?

Answer 13

usually asymptomatic, have murmur
possible signs: syncope, right-sided CHF

Question 14

what is the murmur like in pulmonary stenosis?

Answer 14

loud, harsh ejection quality systolic murmur
second murmur of tricuspid regurgitation on right mid-cardiac region

Question 15

what is the desired outcome from balloon valvuloplasty for pulmonary stenosis?

Answer 15

> 50% reduction in doppler gradient
residual gradient <100mmHg

Question 16

what percentage of cats with heart disease have a congenital heart defect?

Answer 16

8%

Question 17

what percentage of cats have a congenital heart defect?

Answer 17

0.2%

Question 18

how common is a ventricular septal defect in cats with a congenital heart defect?

Answer 18

50%

Question 19

what is a patent ductus arteriosus?

Answer 19

connection between thee aorta and the pulmonary artery

Question 20

what is the mortality rate of uncorrected patent ductus arteriosi?

Answer 20

40-70% die within a year

Question 21

what type of CHF can a patent ductus arteriosus cause?

Answer 21

left-sided CHF

Question 22

what type of murmur is found with a patent ductus arteriosus?

Answer 22

continuous murmur left heart base- axilla
+/- systolic murmur of mitral regurgitation- left apex

Question 23

what can be seen on ECG of patent ductus arteriosus?

Answer 23

some are normal
left ventricular enlargement pattern
P-mitrale- left atrial enlargement pattern
VPC, APC, atrial fibrillation, ventricular tachycardia

Question 24

what can be seen on echo with a patent ductus arteriosus?

Answer 24

left heart volume overload
continuous flow main pulmonary artery
PDA visualized

Question 25

what type of regurgitation can develop with pulmonary stenosis?

Answer 25

secondary tricuspid regurgitation

Question 26

what are some signs of right-sided CHF?

Answer 26

abdominal distension- ascites tachypnea hepatomegaly jugular vein distension +/- pleural effusion

Question 27

where is the apex beat strongest with pulmonary stenosis?

Answer 27

right hemithorax

Question 28

what is moderate pulmonary stenosis doppler gradient?

Answer 28

50-100 mmHg

Question 29

what can be seen on ECG with pulmonary stenosis?

Answer 29

deep S wave in lead II or chest lead