Hx and PE Findings

Question 1

Exercise intolerance, decr. growth, and muscle wasting suggest what type of problem with the heart?

Answer 1

Compromised forward output

Question 2

Ascites and pleural effusion causing dyspnea/tachypnea suggest what problem with the heart?

Answer 2

R-CHF

Question 3

Coughing and exercise intolerance 2* resp compromise suggest what problem with the heart?

Answer 3

L-CHF

Question 4

How can L-CHF cause coughing?

Answer 4

Enlarged L atrium compressing L bronchus

Question 5

What is a common PE finding in cats with CHF?

Answer 5

Low core temp

Question 6

Systemic hypertension may present with what non-cardiac clinical signs?

Answer 6

Ocular lesions/sudden blindness, neuro signs

Question 7

How is BP usually measured in small animals?

Answer 7

Doppler, oscillometric

Question 8

What is normal systolic BP in dogs?

Answer 8

120-150mmHg

Question 9

What is normal systolic BP in cats?

Answer 9

110-140mmHg

Question 10

What is the first (S1) heart sound heard on auscultation?

Answer 10

AV valve closure

Question 11

What is the second (S2) heart sound heard on auscultation?

Answer 11

Semilunar valve closure

Question 12

If you hear a split S2, what does this indicate?

Answer 12

Pulmonic valve closes later than aortic valve, R-CHF

Question 13

When does a systolic click occur?

Answer 13

Between S1 and S2

Question 14

What does a systolic click indicate?

Answer 14

Valve prolapse (often first sign of MVD)

Question 15

Is a gallop rhythm a systolic or diastolic sound?

Answer 15

Diastolic

Question 16

With what heart problems is S3 heard in small animals?

Answer 16

DCM or LV volume overload

Question 17

With what heart problems is S4 heard in small animals?

Answer 17

Atrial kick, non-compliant ventricle

Question 18

Rapid passive filling causes what heart sound?

Answer 18

S3

Question 19

Which gallop sound is the “gallop of heart failure”?

Answer 19

S3

Question 20

Are S3 and S4 normal or abnormal in large animals?

Answer 20

Normal

Question 21

What is the most common cause of a diastolic murmur?

Answer 21

Aortic regurg (older horse, valve degeneration)

Question 22

What is the most common cause of a holosystolic murmur in dogs?

Answer 22

Mitral regurg

Question 23

Where will you auscult a mitral regurgitation?

Answer 23

L apex

Question 24

In small breed dogs with mitral regurgitation, what is the pathogenesis of the condition?

Answer 24

Mitral valve degeneration

Question 25

In large breed dogs with mitral regurgitation, what is the pathogenesis of the condition?

Answer 25

DCM

Question 26

If a younger animal has mitral regurgitation, what is the likely cause?

Answer 26

Mitral valve dysplasia

Question 27

What causes mitral regurgitation in cats?

Answer 27

Mitral valve dysplasia, systolic anterior motion (SAM)

Question 28

Where will you best hear a tricuspid regurgitation?

Answer 28

R apex

Question 29

Why is a tricuspid regurgitation usually lower intensity than a mitral regurgitation?

Answer 29

Lower pressures in the R heart

Question 30

What is the most common cause of tricuspid regurgitation?

Answer 30

Endocardiosis

Question 31

In young dogs, mitral and tricuspid regurgitation must be differentiated from what other defect that also causes a holosystolic murmur?

Answer 31

Ventricular septal defect

Question 32

What is the most common congenital murmur in all species other than dogs?

Answer 32

Ventricular septal defect

Question 33

With VSD, what size defect will produce a louder murmur?

Answer 33

Smaller hole = faster velocity = louder murmur

Question 34

Which side of the heart is a VSD usually best heart?

Answer 34

Right side

Question 35

What are ejection murmurs?

Answer 35

Aortic/pulmonic stenosis, atrial septcal defect

Question 36

What murmur is heard at the left base of the heart and is accompanied by weak femoral pulses?

Answer 36

Aortic stenosis

Question 37

What dog breeds are most prone to aortic stenosis?

Answer 37

GR, Rottie, Boxer

Question 38

How will an aortic stenosis differ from a pulmonic stenosis?

Answer 38

Normal femoral pulses w/pulmonic stenosis

Question 39

In general, which dog breeds are more prone to aortic stenosis?

Answer 39

Large breed

Question 40

In general, which dog breeds are more prone to pulmonic stenosis?

Answer 40

Small dogs

Question 41

What dog breeds are most predisposed to pulmonic stenosis?

Answer 41

Bulldog, beagle, poms, chihuahua

Question 42

Murmur related to increased R-sided flow that is rare both dogs and cats

Answer 42

Atrial septal defect

Question 43

Which dog breed is considered higher risk for atrial septal defect?

Answer 43

Boxer

Question 44

How does an atrial septal defect affect the pulmonic valve?

Answer 44

Relative pulmonic stenosis

Question 45

A continuous murmur indicates what disease?

Answer 45

PDA

Question 46

Washing machine murmur at the L base of the heart indicates what disease?

Answer 46

PDA

Question 47

What type of pulses accompany a PDA?

Answer 47

Water hammer pulses

Question 48

What clinical sign will you see with reverse PDA?

Answer 48

Cyanosis, no murmur

Question 49

What direction is normal PDA flow?

Answer 49

L-to-R

Question 50

What direction is a reverse PDA flow?

Answer 50

R-to-L

Question 51

How does a PDA reverse?

Answer 51

Volume overload in lungs causes constriction and hypertension and elevated R sided pressures

Question 52

Why might DCM not have a murmur?

Answer 52

Poor heart function