Diastolic dysfunction

Question 1

T/F: Pulmonary edema occurs with right heart diastolic dysfunction.

Answer 1

False! Left heart

Question 2

What are some causes of primary diastolic dysfunction?

Answer 2

Hypertrophic obstructive cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy

Question 3

What are some secondary causes of diastolic dysfunction?

Answer 3

Pressure overload diseases

Pericardial diseases

Question 4

What level of systolic BP is too high persistently at home? What is a better cut off for stressed out animals during an exam?

Answer 4

160 mmHg

180-200 mmHg

Question 5

List some causes of secondary systemic hypertension?

Answer 5

Hyperaldosteronism
Pheochromocytoma
Acromegaly
Medications
Diabetes mellitus
Hyper/hypothyroidism
Hyperadrenocorticism
Renal disease

Question 6

What are the target organs for systemic hypertension

Answer 6

Brain, eyes, heart, kidney

Question 7

T/F: If retinal changes are occuring, blood pressure is likely very high.

Answer 7

True

Question 8

What retinal changes do you expect to see with systemic hypertension?

Answer 8

Vascular distension and tortuosity, retinal hemorrage

Question 9

With concentric hypertrophy, do you expect fibrosis to be in the lumen or near the epicardium?

Answer 9

In the lumen, the cardiac vasculature comes from the outside, and blood vessels do not grow as the muscle hypertrophies, resulting in fibrosis

Question 10

T/F: Systemic hypertension can be caused by primary heart disease.

Answer 10

False- should be normo to hypotensive with primary heart disease

Question 11

T/F: On echocardiography, the walls of the ventricles should not touch in diastole or systole.

Answer 11

True!

Question 12

What is the goal of treatment for systemic hypertension?

Answer 12

Decrease the blood pressure!

Question 13

What classes of drugs can be used to decrease systemic vascular resistance?

Answer 13

ACE inhibitors
Alpha antagonist
Calcium channel blockers

Question 14

What class of drugs can be used to decrease heart rate in cases of systemic hypertension?

Answer 14

Beta blockers

Question 15

What is drug of choice for cats with renal disease to decrease blood pressure?

Answer 15

Amlodipine- CCB

Question 16

What class of drugs are particularly good for cases of hypertension with proteinuria?

Answer 16

ACE inhibitors

- block peripheral vasoconstriction and efferent arteriolar vasoconstriction

Question 17

T/F: Diuretics are first line drugs for systemic hypertension

Answer 17

False- especially with kidney disease, can make the problem worse

Question 18

What species of cats is hypertrophic cardiomyopathy common in?

Answer 18

Maine coons, ragdolls

Question 19

T/F: Primary HCM is a diagnosis of exclusion of all causes of secondary HCM

Answer 19

True

Question 20

T/F: Cats can get pulmonary edema or pleural effusion with left sided CHF

Answer 20

True

Question 21

T/F: Cats with arterial thromboemboli should be taken to surgery to remove the thrombus.

Answer 21

False, aside from them being poor surgical candidates, removing the clot can result in reperfusion injury.

Question 22

What are 4 ECG changes seen with feline arterial thromboembolism induced hyperkalemia from reperfusion injury?

Answer 22

1. tented t waves
2. decreased p wave amplitude or absent
3. increased PR interval
4. wide QRS complexes

then… CARDIAC ARREST !