Intro to heart disease Flashcards
What causes weak pulses?
reduced cardiac output
- Systolic dysfunction
- Outflow obstruction
- pulmonic stenosis
• Hypovolaemia
- Haemorrhage
- Septic shock…
• Hypertension
What kind of pulse do you get with a PDA?
Waterhammer
What is the hepatojugular reflex?
In right sided failure
Pressure on the cranial abdomen = increased venous return to the RHS of the heart
See pulsation rise up the jugular groove/ jugular distension
What to systolic murmurs suggest in different areas in the heart?
Left apex - mitral regurge/ VSD
R apex - tricuspid regurge
L base - outflow tract obstruction/ pysiological murmur/ PDA (constant)
R base - VSD (v forward)/ aortic or pulmonic stenosis
What are the ddx for a left apex murmur?
Valvular disease •Degenerative •Dysplastic Annular stretch (dilation) •DCM •PDA, MDVD etc... Ventricular hypertrophy
What are the DDx for a right apex (tricuspid regurge) murmur?
Valvular disease
Annular stretch
Ventricular hypertrophy
NB Pulmonary hypertension can produce a loud murmur, the rest tend to be quieter
What are the ddx for a left base murmur?
Aortic stenosis
Pulmonic stenosis
Physiological
•Conformation (v large dogs having sinus arrhythmia may have a pause then murmur)
•Heart rate
•Blood viscosity (e.g. anaemia/ hyperproteinaemia)
•High output states (e.g. pyrexia)
What is mitral regurge associated with in cats?
HCM
What are the primary heart disease ddx for murmurs in cats?
Dynamic left or right ventricular outflow tract obstruction
Obstruction caused by any other hypertrophied structures
• Mitral regurgitation
• Tricuspid regurgitation
• Congenital heart defect
What are the non cardia ddx for murmurs in cats?
IVFT
hyperthyroidism
anaemia
What are the ddx for diastolic murmurs?
Apex • Mitral stenosis • (Tricuspid stenosis) •Base • Aortic regurgitation • PDA • (Pulmonic regurgitation)
What are the 5 categories of Ddx for tachypnoea/ dyspnoea/ cough?
URT (obstruction) Airwarys pulmonary parenchyma pleural space other
What are the ddx of airway disease causing tachypnoea/ dyspnoea?
Bronchial disease • Inflammatory • Feline asthma • Infectious Neoplastic
What are the ddx of pulmonary parenchyma disease causing tachypnoea/ dyspnoea?
Oedema • Cardiac • Non‐cardiogenic - strangulation/ electrocution/ seizure Cellular infiltrate • Pneumonia - Viral/bacterial/parasitic • Neoplasia • Haemorrhage Fibrosis
What are the ddx of pleural space disease causing tachypnoea/ dyspnoea?
Effusion • Cardiac • Pyothorax • Neoplastic • Chylothorax Pneumothorax Mass lesions - lymphoma and mesothelioma most common
What are the ddx of ‘other’ diseases causing tachypnoea/ dyspnoea?
- Acidosis
- Respiratory muscle failure
- Pyrexia
- Respiratory compromise
- Ascites
What are the URT ddx for cough?
- Laryngeal paralysis
* Infectious tracheobronchitis
What are the lower airway ddx for cough?
Bronchial disease
Cardiac enlargement
What are the pulmonary parenchyma ddx for cough?
Oedema • Cardiac • Non‐cardiogenic Cellular infiltrate • Pneumonia - Viral/bacterial/parasitic • Neoplasia • Haemorrhage Fibrosis
What are the pleural space ddx for cough?
Pleural space • Mass lesions Mediastinum • Mass lesions • Inflammation
What are the ‘other’ ddx for cough?
Pharyngeal disease
Reverse sneeze
Vomit
How can you differentiate a respiratory and cardiac cough
Cardiac - won’t have sinus arrythmia
- cough at night often
- tachycardia
- possible murmur
- exercise intolerance
Resp - cough on excitement/ exercise
- may be productive
What are the main groups of ddx for collapse?
Metabolic Resp CV Musculoskeletal Neuro
What are the neuro ddx for collapse
Seizure
narcolepsy
transient ischaemic attack
Stroke
