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cardiology > CV Exam, Radiography, Echo > Flashcards

CV Exam, Radiography, Echo Flashcards

1
Q

What heart disease do you think of with old dogs

A

mitral valve degeneration

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2
Q

What heart disease do you think about with middle aged cats?

what about older cats?

A

Middle aged: hypertrophic cardiomyopathies

Old cats: systemic disease and secondary CV effects (hyperthroud)

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3
Q

What heart disease do you think of with younger horses

A

heart rhythm disturbances
-atrial fibrillation

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4
Q

what heart disease do you think of with older horses

A

aortic valve degeneration

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5
Q

what heart disease do you think of in cattle

A

right atrial lymphoma
endocarditis
pericardial disease
high altitude

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6
Q

Is PDA more common in male or female dogs

A

Females (3x more likely)

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7
Q

Is hypertrophic cardiomyopathy more common in male or female cats

A

males

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8
Q

Clinical signs of CV disease

A

-lethargy, exercise intolerance, reduced activity
-separation, hiding behavior
-syncope or exertional weakness
-respiratory signs (cough, rapid breathing)
-abdominal distension or subcutanous edema
-muscle/weight loss with chronic cardiac disease
-acute paresis (limb lameness)
-regurgitation

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9
Q

a brief loss of consciousness and postural tone due to reduced cerebral blood flow
may be caused by 1) abnormal heart rhythms, 2) excess vasodilation;
3) plasma volume contraction

A

syncope

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10
Q

what sign of heart disease might be confused with seizures

A

syncope
a brief loss of consciousness and postural tone due to reduced cerebral blood flow

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11
Q

What is unique about cats and horses during syncope events

A

looks like a focal seizure
-facial twitching is common

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12
Q

why do cats with heart disease typically cough

A

dogs do often cought as their is fluid accumulation in the lungs or pleural space
HOWEVER
cats seldom cough- respiratory signs are more often related to rapid (tachypnea) or labored (dyspnea) breathing

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13
Q

Dogs often cough as a respiratory sign of heart disease but cats do not. What will you see instead?

A

more often tachypnea (rapid breathing) or labored (dyspnea)

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14
Q

abnormality in respiration where the animal is breathing fast, typically more shallow

A

tachypnea

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15
Q

abnormality in respiration where the animal is breathing deeper

A

hyperpnea

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16
Q

abnormality in respiration where the animal is breathing in distress

A

dyspnea

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17
Q

exertional respiratory signs (abnormal respirations after periods of activity) of heart disease is seen in animals with

A

limited cardiopulmonary capacity
1) pulmonary hypertension
2) cyanotic heart disease
3) severe systolic dysfunction
4) congestive heart failure

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18
Q

what is one of the best things that you can have your client do to predict heart failure in an animal

A

client measured respiratory rate
do for patients at risk of heart disease

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19
Q

what is the difference between a cough vs reverse sneeze

A

cough: forced exhalation (lower airway)

reverse sneeze: forced inhalation (pharynx/upper airway)

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20
Q

what is a common sign of right sided CHF in dogs

A

cavitary effusion, often seen as ascites

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21
Q

what is a common sign in large animals with CHF, whether left sided or right sided

A

cavitary effusion (abdominal distension)

-Brisket edema

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22
Q

Cavitary effusion, often seen as ascites is a common sign of

A

right sided CHF

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23
Q

if animal has an AV fistula connection the femoral artery to the femoral vein. what might occur

A

swelling of the extremities (pelvic limb)

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24
Q

How might you get swelling of the extremities

A

1) high filling pressure
2) vascular obstruction
3) vascular communication (AV shunt)

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25
Q

limb paresis/claudication might be a potential sign of

A

arterial obstruction
need to rule out musculoskeletal and neurologic causes

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26
Q

cardiac cachexia

A

due to chronic heart failure resulting in catabolic state
protein is loss in cavitary effusions
edematous GI tract with poor absorption
impaired perfusion of vital organs

*end result is severe muscle and condition loss

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27
Q

How can we get cachexia with chronic heart failure

A

ailure resulting in catabolic state
protein is loss in cavitary effusions
edematous GI tract with poor absorption
impaired perfusion of vital organs

*end result is severe muscle and condition loss

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28
Q

why might you see regurgitation with esophageal dysfunction

A

vascular ring anomalies (persistent right aortic arch around the esophagus)

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29
Q

what does it mean if the mucous membranes are pale/white

A

anemia
poor cardiac output
severe vasoconstriction

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30
Q

What is the diaphragm of the stethoscope use for

A

high frequency sounds (nx heart and lung)

firm pressure with one-sided

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31
Q

what is the bell of the stethoscope used for

A

low frequency sounds such as gallops

light pressure with one sided

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32
Q

heaptojugular reflex

A

used for better evaluation of the jugular vein

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33
Q

what do pink mucous membranes mean

A

normal

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34
Q

what do red mucous membranes mean

A

vasodilation, erythrocytosis, stress

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35
Q

what do blue/purple mucous membranes mean

A

cyanosis (hypoxemia)
desaturated hemoglobin

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36
Q

a normal pulse is

A

palpable with light touch

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37
Q

a weak pulse is

A

hard to feel, occluded with light pressure

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38
Q

a strong pulse is

A

easy palpable, hard to occlude with firm pressure; felt in small peripheral arteries

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39
Q

what might be occuring if you notice a weak pulse

A

1) hypovolemia
2) poor cardiac output
3) LV outflow obstruction (subaortic stenosis)

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40
Q

what might be occurring if you notice a strong/bounding pulse

A

1) abnormal diastolic runoff of blood (AV shunt, PDA, aortic regurgitation
2) bradycardia- causing lowe diastole
3) Vasodilation- reduced vascular resistance (fever, anemia, exercise, thyroid, drugs)
4) High sympathetic tone
5) age and stiffening of arteries

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41
Q

when might pulse deficits occur

A

when there is an abnormal heart rhythm causing the heart to contract prematurely and close the AV valves but the stroke volume of the early beat may be inadequate to open the aortic valve or to lead to a palpable pulse in the peripheral artery

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42
Q

what might distension of the jugular veins tell you

A

increased plasma volume
or
impaired venous return back to heart (Right side disease, pericardial dz, cranial vena cava thrombis)

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43
Q

What might pulsation of the jugular veins tell you

A

there are refleted waves
1) tricuspid regurgitation
2) stiff/noncompliant right ventricle

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44
Q

what can retinal vessels and hemorrhage tell you

A

high blood pressure

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45
Q

What valves can you hear on the left side

A

start with mitral valve then go dorsal and a little cranial to hear the aortic valve then continue for the pulmonic
(PAM- cranial to caudal)

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46
Q

what can you hear on the right side

A

tricuspid valve
and ascending aorta

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47
Q

In cats when doing cardiac exams, localizing cardiac valves is much more difficult due to the size. What do you do instead

A

Locations are described as parasternal
*Left
*right and cranial
*caudal
not necessarily discrete valve locations

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48
Q

what can you do to get rid of purring when trying to evaluate the heart of a cat

A

use running water, alcohol in front of the nose, gentle pressure on larynx

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49
Q

artifacts that obscure auscultation

A

1) respiration and panting- may be louder than heart can sound like a murmur
2) purring: onscures ausculatation
3) excessive pressure- compliant thorac (kitten, puppy, chinchilla) your stethoscope pressure maycompress vessels and cause a murmur
4) moving the chest piece over the fur
5) muscle twitches

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50
Q

abrupt changes in pressure and flow; short duration (heart sounds)

A

transient sounds

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51
Q

T/F: in large animals both the 3rd and 4th heart sounds can be normal (diastolic soundsO

A

True
atrial contraction pushing blood into ventricle

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52
Q

phonocardiogram

A

allows you to see heart sounds graphically
not commonly employed

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53
Q

What causes the S1 sound

A

closure of mitral valve and tricuspid valve

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54
Q

what causes the S2 sound

A

closure of the aortic valve and pulmonic valve

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55
Q

what causes the S3 sound

A

early diastolic filling

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56
Q

what causes the S4 sound

A

late diastolic filling

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57
Q

where does S1 have the greatest intensity

A

at the apex

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58
Q

where does S2 have the greatest intensity

A

at the heart base

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59
Q

why might the heart sound intensity be softer

A

-obesity
-fluid accumulation (pleural or pericardial)
-myocardial failure (reduced contractility)
-mass lesion (diaphragmatic hernia)

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60
Q

when might the heart sound intensity be louder than expected

A

-increased sympathetic tone
-hypertension (systemic or pulmonary)

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61
Q

normal dog heart rate (in hospital)

A

70-150

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62
Q

normal cat heart rate (in hospital)

A

140-220

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63
Q

normal cow heart rate (in hospital)

A

45-70

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64
Q

normal horse heart rate (in hospital)

A

30-50

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65
Q

a regularly irregular heat rhythm

A

sinus arrhythmia

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66
Q

an irregularly irregular heart rhythm

A

atrial fibrillation
(no consistency)

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67
Q

diastolic sounds associated with ventricular filling

A

gallops

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68
Q

a mid-systolic event usually related to valve prolapse (between S1 and S2)

A

clicks
due to mitral or tricuspid valve prolapse

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69
Q

what heart sound occurs between between S1 and S2

A

clicks

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70
Q

where S1 and S2 sounds are the fusion of 2 valve closing
Separation (MV then TV or AoV then PV) causes splitting

A

Splitting

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71
Q

What does an S3 sound indicate

A

vibrations during early diastolic filling
normal in large animals but in small animals it is a sign of heart failure due to rapid filling that abruptly stops

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72
Q

What does an S4 sound indicate

A

vibrations during late diastolic filling (after atrial contraction)
normal in large animals but in small animals means related to a stiff or poorly relaxing ventricle that is filled rapidly after atrial contraction

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73
Q

What might be the cause for a mid-systolic click

A

prolapse of the mitral or tricuspid valve

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74
Q

what might cause split heart sounds

A

1) sometimes only appreciated as the normal heart sound lasting longer than expected
2) often related to respiration (prolongation of P2 with right sided filling)

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75
Q

a prolonged audible vibration during a normally silent period of cardiac cycle

A

murmur
*often a sign of underlying heart disease but innocent and physiological murmurs can occur

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76
Q

vibrations become audible when blood flow becomes turbulent due to:

A

1) Increased velocity
2) Decreased viscosity
3) Flow into a large receiving chamber

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77
Q

Proto

A

early murmur (protosystolic)

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78
Q

meso

A

mid murmur (mesosystolic)

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79
Q

tele

A

late murmur (telesystolic)

80
Q

holo

A

throughout phase murmur
(holodiastolic)

81
Q

How are murmurs graded

A

on a 6 tier scale
1: nearly imperceptible. may be heart with very careful auscultation in quiet environment, always focal
2: heard readily but very soft; always focal
3: Heard readily, moderate intensity, usually regional (can only be heard in several auscultatory regions)
4: heard readily, loud, and usually radiates widely (can be heard in most or all auscultatory region of the heart) but without palpable thrill
5: Heard readily loud and associated with precordial thrill, but the murmur is not heard with the stethoscope lifted off the surface of the thorax
6: Heard readily, loud, associated with precordial thrill, murmur remains audible with stethoscope lifted 1 cm off the surface of thorax

82
Q

Rate the murmur:
nearly imperceptible. may be heart with very careful auscultation in quiet environment, always focal

A

grade 1 murmur

83
Q

Rate the murmur: heard readily but very soft; always focal

A

grade 2 murmur

84
Q

Rate the murmur: Heard readily, moderate intensity, usually regional (can only be heard in several auscultatory regions)

A

grade 3 murmur

85
Q

Rate the murmur: heard readily, loud, and usually radiates widely (can be heard in most or all auscultatory region of the heart) but without palpable thrill

A

grade 4 murmur

86
Q

Rate the murmur: Heard readily loud and associated with precordial thrill, but the murmur is not heard with the stethoscope lifted off the surface of the thorax

A

grade 5 murmur

87
Q

Rate the murmur: Heard readily, loud, associated with precordial thrill, murmur remains audible with stethoscope lifted 1 cm off the surface of thorax

A

grade 6 murmur

88
Q

murmurs that occur between or obscuring S1 and S2

A

systolic murmur

89
Q

murmurs that occur after S2 often dies off slowly

A

diastolic murmur

90
Q

Continuous murmurs

A

murmurs with same sound quality, variable intensity

91
Q

To-and-Fro murmurs

A

murmurs with separate systolic and diastolic murmurs (windshield wipers)

92
Q

What are the 6 ‘S’ that suggest an innocent heart murmur

A

Sensitive (changes with positiion/respiration)

Short duration (protosystolic)

Single (no associated clicks/gallops

Small (limited to a small area, does not radiate)

Soft (low amplitude)

Systolic (limited to systole)

93
Q

what might scratching sounds indicate

A

friction/grating between two pericardial layers
heard most often in large animals with inflammatory pericarditis

94
Q

is a vibratory sound produced by narrowed large air passages usually worse during inspiration. it usually reflects large airway obstruction (larynx, trachea, etc)

A

stridor

95
Q

harsh, snoring sound, usually inspiratory. it is typically related to soft palate obstruction or secretion in upper airway
-nasopharyngeal foreign body or nasopharyngeal stenosis

A

stertor

96
Q

abnormal breath sounds that reflect small airway collapse, usually expiratory and high pitched
-ex: asthma

A

wheezes

97
Q

harsh, popping sounds related to rapid opening of collapse airways or alveoli
-fluid or fibrosis

A

crackles

98
Q

T/F: you cannot tell left versus right on a lateral radiograph

A

True

99
Q

VD radiograph

A

a radiograph view that was taken with the animal lying on their back (dorsorecumbency)

100
Q

DV radiograph

A

a radiograph view that was taken with the animal lying on their sternum (sternalrecumbency)

101
Q

What are the differences between VD and DV radiograph views

A

VD: diaphragmatic crura are more obvious and better for the lungs

DV: better for CV structures, pleural fluid more obvious, though it obscures the structures

102
Q

What radiograph view makes the 2 diaphragmatic crura more obvious

A

VD

DV- looks more like a dome instead

103
Q

What radiograph view is preferred for lung evaluation

A

VD

104
Q

Is DV or VD better for evaluating cardiovascular structures

A

DV

105
Q

Is DV or VD preferred for lungs

A

VD

106
Q

is pleural fluid more obvious on DV or VD

A

DV, though it obscures the structures

107
Q

What are some differences in thoracic radiographs in cats versus dogs

A

Cats:
1) Heart lays more horizontal (dog is more vertically oriented)
2) Thorax is more triangular
3) Elongated vertebral bodies and sternebrae
4) Finer fibers
5) often more lung between cardiac silhouette and diaphragm

108
Q

On radiograph you see a bulge toward the craniodorsal aspect of the cardiac silhoutte (lateral projection) and a dilation in the 9 to 11 o’clock position (DV or VD)

A

Right Atrial Enlargement

109
Q

What would you see on radiograph of an animal with right atrial enlargement

A

Lateral: bulge toward the craniodorsal aspect of the cardiac silhoutte

DV/VD: dilation in the 9-11 o’clock position

110
Q

On VD/DV radiography, the left side of the screen is always the

A

right side of the animal

111
Q

What would you see on radiograph of an animal with right ventricular enlargement (ex: from pulmonary valve stenosis)

A

Lateral: wider appearance to cardiac silhouette

DV/VD: displacement of the cardiac silhouette to the right in the 6 to 9oclock position creating the reversed D sign

112
Q

On lateral radiograph you see a wider appearance to the cardiac silhouette and on DV/VD you see displacement of the cardiac silhouette to the right in the 6-9o’clock position (creating a reverse D). What is likely the cause

A

Right ventricular enlargement (could be from pulmonary valve stenosis)

113
Q

orthogonal radiographs

A

radiograph obtained from 90 degrees from the original view
(ex: VD/DV)

114
Q

Upon VD/DV radiography you notice enlargement at the 1-2 oclock position. What could be occuring

A

pulmonary artery is enlarged
-pulmonary hypertension possibly

left and right pulmonary artery branches often appear dilated relative to their corresponding vein

115
Q

What do you see on radiography of a patient with an enlarged pulmonary artery (could be from pulmonary hypertension)

A

Upon VD/DV radiography you notice enlargement at the 1-2 oclock position

116
Q

What is seen on radiography of a patient with left atrial enlargement (could be from mitral stenosis)

A

Lateral: bulge at the caudal cardiac waist- backpack sign

Vertebral left atrial score >2.3

VD/DV: spreading of bronchi (bow-legged cowboy)

double opacity sign as the enlarged left atrium extends caudally

117
Q

What vertebral left atrial score is indicative of left atrial enlargement

A

> 2.3

118
Q

you will see the spreading of bronchi on DV/VD radiography with

A

left atrial enlargement
-it sits fairly centrally
(bow-legged cowboy)

119
Q

Upon lateral radiography you see a bulge at the caudal cardiac waist and upon VD/DV you see spreading of the bronchi an a double opacity sign. What are you suspicious of

A

left atrial enlargement (ex: mitral stenosis)

120
Q

What would you see on radiograph in a dog with mitral stenosis

A

left atrial enlargement

Lateral: bulge at the caudal cardiac waist- backpack sign

Vertebral left atrial score >2.3

VD/DV: spreading of bronchi (bow-legged cowboy)

double opacity sign as the enlarged left atrium extends caudally

121
Q

What would you see on radiography of a dog with pulmonary valve stenosis

A

right ventricular enlargement
Lateral: wider appearance to cardiac silhouette

DV/VD: displacement of the cardiac silhouette to the right in the 6 to 9oclock position creating the reversed D sign

122
Q

What might you see on radiography of a dog with subaortic stenosis

A

Left ventricular enlargement

Lateral: appears taller on radiography (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)

VD/DV: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock

123
Q

On lateral radiograph you see taller heart (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)
on VD/VD: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock

A

Left ventricular enlargement (ex: subaortic stenosis)

124
Q

What are the signs of left ventricular enlargement on radiography

A

Lateral: appears taller on radiography (carina becomes elevated toward the spine, lessening the angle between the spine and trachea)

VD/DV: elongation of the cardiac silhouette with bulge in the left caudal thorax, roughly at 3-6 o’clock

125
Q

What might you see on radiography of a patient with aortic enlargement

A

could be from small PDA
bulge at cranial cardiac waist on lateral (more cranial than the right ventricle)

prominence from 11 to 1 o’clock on DV/VD

often appears as widening of cranial mediastinum

dilation contiguous with descending aorta

126
Q

Upon lateral radiography you see bulge at cranial cardiac waist on lateral and then prominence from 11 to 1 o’clock on DV/VD, often appears as widening of cranial mediastinum
What is your diagnosis

A

aortic enlargement
-could be from a small PDA

127
Q

How do you take a vertebral heart score

A

Line from: ventral aspect of corina to the apex of heart (long axis)

Line from the widest part of the cardiac silhouette

compare this to the number of vertebral bodies starting at the 4th vertebral body

add up the short and long axis to get the total score

normal = 9.7 +/- 0.5

128
Q

What is the normal vertebral heart score

A

9.7 +/- 0.5

129
Q

vertebral left atrial size (VLAS)

A

an alternate measure of cardiac enlargement specific to the left atrium

-ventral carina to the caudal left atrium border at the level of the caudal vena cava

A score of >2.3 vertebral bodies predicts an enlarged LA

130
Q

what lines do you draw for vertebral left atrial size (VLAS)

A

ventral carina to the caudal left atrium border at the level of the caudal vena cava

131
Q

What are some issues with VHS (vertebral heart score) and VLAS ( Vertebral left atrial size)

A

Hemivertebrae

Structures (fat summating with cardiac silhouette

Breed differences (ex: bulldog 12.7 +/- 1.7 is normal for breed)

132
Q

On VD/DV radiograph, veins are

A

ventral and central

133
Q

on lateral radiograph, veins are

A

ventral and centra;

134
Q

bronchial lung pattern

A

increased opacity of airway walls
fluid or cellular material in bronchial wall, lumen, or peribronchial space
-usually related to airways inflammation
looks like sponge

135
Q

pathologic dilation of bronchi, usually related to chronic inflammatory and damage to the bronchial wall

A

bronchiectasis

136
Q

interstitial unstructured pattern

A

increased fluid/cells in the pulmonary interstitial space on radiograph

unstructured is a diffuse, hazy appearance obscuring your ability to see normal vessels

137
Q

what are your differentials for pulmonary nodules in radiograph

A

-Tumor
-Granuloma
-Abscess
-Cyst

-Cavitary nodules: lungwomrs, pgas producing abscess, atypial neoplasia

138
Q

a pattern on radiography where the alveoli are filled with fluid/debris
appearance is comparable to trees in snowstorm.

A

alveolar pattern

139
Q

a pattern on radiography where there is a clear delineation between the alveolar pattern in the right middle lung lobe and the aerated right cranial lung lobe

A

lobar sign

140
Q

air filled nodules on radiography
less common than soft tissue nodules.
differentials include lungworms, gas-producing abscess or atypical neoplasia

A

cavitary lung nodules

141
Q

what does a pneumothorax look like on radiography

A

the heart will appear elevated from the sternum as it falls to the side of collapse when in lateral

no lung markings -> atelectatic (collapsed) lung

142
Q

What does it mean when on lateral radiography you see the heart is elevated from the sternum

A

pneumothorax

143
Q

what will pleural effusion look like on radiography

A

fluid opacity surrounding the lungs causing pleural fissure lines and obscuring our ability to view the heart

144
Q

You see fluid opacity surrounding the lungs causing pleural fissure lines and obscuring our ability to view the heart. What likely is occuring

A

pleural effusion

145
Q

Why might there be decreased lung vasculature on radiography

A

tetralogy of fallot

pulmonary hypoperfusion due to shunt

146
Q

why might there be increased lung vasculature on radiography

A

advanced heart worm disease

pulmonary arterial enlargement

147
Q

higher frequency probes have

A

higher resolution and lower penetration
7-12 MHz probes are used in cats and small dogs

148
Q

lower frequency probes have

A

lower resolution but higher penetrations
3-5Hz= large dogs and horses

149
Q

what are the basic physics of ultrasound

A

1) Sound waves travel through a medium and are either reflected, scattered, or absorbed
2) Sound waves are reflected back when there is a difference in density between tissues

150
Q

What can echocardiography tell you about the structure and function of the heart

A

Structure
1) remodeling- eccentric and concentric hypertrophy
2) Valve morphology- dysplasia, degeneration, infection
3) Defects- vascular and septal
4) Pericardial disorders
5) Heartworms, neoplasia, thrombus

Function
1) Systolic and diastolic
2) Valvular dysfunction- prolapse, stenosis, insufficiency
3) Pericardial tamponade
4) Abnormal blood flow

151
Q

What are the two positions you echo an animal in

A

Right parasternal image.
1) right 3rd and 6th intercostal spaces between sternum, and costochondral junctions

Left parasternal image:
1) Left caudal (apical) location between the left 5th and 7th intercostal spaces and close to sternum
2) Left cranial location located between the left 3rd and 4th intercostal spaces between the sternum and costochondral junction

152
Q

right 3rd and 6th intercostal spaces between sternum, and costochondral junctions

A

right parasternal images
see:
1) long axis 4 chamber view
2) fan to see long axis LV outflow view with aorta
3) short axis. Fan from A (all LV) then fanning up with increasing RV crescent

153
Q

Left caudal (apical) location between the left 5th and 7th intercostal spaces and close to sternum

A

left caudal (apical) parasternal
1) right at apex looking up for 4 chamber inflow view (RV,LV,RA,LA) and 5 chamber LV outflow view (RV, LV, RA,Ao, LA)

2) Long axis 2 chamber view LV, LA, Left auricle to look at left auricle in cats

154
Q

Left cranial location located between the left 3rd and 4th intercostal spaces between the sternum and costochondral junction

A

Left cranial parasternal images
1) Short axis view
2) Long axis view to view Aorta, R aurcle, Pulmonary valves

155
Q

why might you want to look at the long-axis 2 chamber view in left caudal parasternal for a cat

A

you want to look at the left auricle bc of saddle thrombus

156
Q

what do you want to assess of right parasternal long axis 4 chamber view

A

1) Interatrial and ventricular septum should not be bowed
(Higher pressure on one side)
2) Interventricular septum and LV free wall should be similar in thickness
3) RV free wall should be 1/2 the LV free wall thickness

157
Q

The interventricular septum should be __________ as the LV free wall and the LV free wall should be ______ than the RV

A

the same
twice the thickness

158
Q

The RV chamber should be ________ dimension of the LV in right parasternal long axis 4 chamber view

A

1/3

159
Q

Upon right parasternal long axis 4 chamber view, you see that the LV and LA is dilated with decreased systolic function. What is the diagnosis

A

Dilated cardiomyopathy (DCM)

160
Q

On the right parasternal long axis 5 chamber view, the left atrium is ________ the size of the aorta

A

1:1

161
Q

What does it mean when on right parasternal long axis 5 chamber view you notice the interventircular septum extendind into the LV outflow tract

A

there is some sort of subarotic ridge or hypertrophy

Subaortic stenosis

162
Q

On right parasternal long axis 5 chamber view, the RV chamber should be _____ dimension of LV

A

1/3

163
Q

How do you diagnose subaortic stenosis on right parasternal long axis 5 chamber view

A

you see the interventricular septum extending into the LV outflow tract
(subaortic ridge/tunnel)
LV concentric hypertrophy and LV dilation

164
Q

what should you see on right patasternal short axis view of the left ventricle

A

1) Symmetrical papillary muscles
2) Uniform shortening
3) No flattening of the interventricular septum (pressure of RV pushing down)
4) Irregularities on the RV side of interventricular septum are normal
*may see RV papillary muscles

-Mushroom view

165
Q

when do you see the mushroom view on echo

A

right parasternal short axis views of the left ventricle

166
Q

what does a squished mushroom view on right parasternal short axis view of the left ventricle mean

A

there is a pressure overload leading to right ventricular hypertrophy pushing on the left ventricle and flattening of the IVS
two differentials
1) Pulmonary valve stenosis
2) pulmonary hypertension

167
Q

Upon doing right parasternal short axis view of the left ventricle you see flattening of the interventricular septum and right ventricular concentric hypertrophy. what are two possible diagnosis

A

1) Pulmonary valve stenosis
2) Pulmonary hypertension

168
Q

What should you see when doing right parasternal short axis view of the mitral valve

A

fish mouth view
1) assess mitral valve leaflets for thickening or prolapse
2) Uniform shortening
3) no flattening of the IVS

169
Q

UPon right parasternal short axis view of the mitral valve (fish mouth) you see thickened mitral valve leaflets and prolapse of anterior leaflet. What is your diagnosis?

A

Degenerative mitral valve disease

170
Q

What should you assess on right parasternal short axis view of the base

A

Assess
1) Left atrial size (Left atrium:Aorta ratio) normal is <1.3-1.5
2) Aortic valve cusps for excursion, thickness, or lesions

171
Q

What is a normal LA:Ao ratio on right parasternal short axis views of the heart base

A

<1.3-1.5

172
Q

What might you see on right parasternal short axis view of the base in a patient with degenerative mitral valve disease

A

1) Enlarged Left Atrium (La:Ao = >1.3-1.5)

173
Q

What should you asssess when right parasternal short axis views of RVOT

A

1) Aorta and pulmonary artery should be similar in diameter
2) Right and left branch pulmonary arteries

174
Q

What should you assess on left caudal (apical) four chamber view

A

1) Mitral and tricuspid valve leaflets for thickening, lesions, prolapse/flail
2) Right atrium should be smaller than left atrium (at this view)
*Used for volume assessment to calculate ejection fraction (EF)

175
Q

What is a good view to compare the two atrium sizes

A

left caudal (apical) 34 chamber view
*the right atrium should be smaller than the left atrium

176
Q

What is a good view to assess and calculate the ejection fraction (EF)

A

Left caudal (apical) four chamber view

it should be greater than 50%

177
Q

How do you determine the ejection fraction on echo

A

1) Left caudal (apical) four chamber view

End diastolic volume-End Systolic Volume / End Diastolic Volume

Normal EF >50%

178
Q

What is a good echo view to assess the aortic valve and left ventricular outflow velocity

A

Left caudal (apical) five chamber view (RV, RA, LV, LA, Ao)

179
Q

What should you assess on the left caudal (apical) five chamber view

A

1) Aortic valve and left ventricular outflow velocity
2 Mitral valve for thickening, lesions or prolapse/flail

180
Q

What echo view should you do to assess for right auricular masses

A

Left cranial long axis views- right atrium and auricle

181
Q

Why might you want to use a left cranial long axis view of the right atrium and auricle

A

to look at the auricle for right atrial/aurciular mass (hemangiosarcoma) or to assess pericardial effusion

182
Q

What view is helpful for looking at the left auricle in cats (clots of blood that could lead to thrombi)

A

left cranial short axis view of left auricle

183
Q

what is M-mode

A

motion mode echocardiography
cursor is placed through 2D image and the location of each interface is represented by a line, which provides information about its temorpral locaton

184
Q

On M-Mode echo, the depth is

A

expressed vertically on image

185
Q

On M-mode echo, time is

A

expressed horizontally on image

186
Q

What is normal fractional shortening (FS) from M-mode

A

Dog (normal): 30-46%
Cat (normal): 40-65%

187
Q

technique that displays blood flow measurements graphically
-velocity of blood flow
-duration of flow
-directionality of flow
-quantification of blood flow

A

spectral dopplers

188
Q

measures velocity along the entire path of the ultrasound beam: __________

measures velocity at a specific location (limited to maximum range of velocities measured: ____________

A

continuous wave doppler

pulsed wave doppler

189
Q

What is the application of measuring vessel velocity with spectral doppler

A

estimate the pressure from velocity of blood flow through the heart

Simplified Bernoulli equation
P=4v^2

190
Q

How do you determine pressure of a specific area on echo

A

use spectral doppler to determine the flow velocities then use the simplified Bernoulli equation
P=4v^2

191
Q

allows visualization of flow direction and velocity within a user defined area

A

Color flow doppler

192
Q

On color flow doppler, what color is blood flow away from the probe

A

blue

193
Q

on color flow doppler, what color is blood flow towards the probe

A

red

194
Q
A
195
Q

What do green or yellow colors on color flow doppler mean

A

areas of high flow turbulence (abnormal)

cardiology (8 decks)

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