Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Module 15 > Acquired Murmurs in Adult Cats > Flashcards

Acquired Murmurs in Adult Cats Flashcards

1
Q

what is the definition of acquired

A

not present at birth

acquired during life (though may be caused by/predisposed to by a genetic abnormality)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the definition of a murmur

A

an abnormal heart sound caused by turbulent blood flow ex. valvular incompetence/insufficiency (a “leaky” valve) or stenosis (narrowing) or an abnormal connection (ventricular septal defect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are acquired murmurs in cats (2)

A
  1. cardiomyopathies –> myocardial disorders
  2. endocardial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the types of cardiomyopathies

A

primary (cause unknown; idiopathic)

secondary (cause known)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the types of endocardial disease (2)

A
  1. degenerative valve disease
  2. endocarditis (bacterial)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the cardiomyopathy phenotypes in cats (5)

A
  1. hypertrophic cardiomyopathy (HCM)
  2. restrictive cardiomyopathy (RCM)
  3. dilated cardiomyopathy (DCM) –> primary and secondary
  4. arrhythmogenic (right) ventricular cardiomyopathy (ARVC)
  5. nonspecific/unclassified cardiomyopathy (UCM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are important rule outs with hypertrophic cardiomyopathy (HCM) (4)

A
  1. hypertension
  2. hyperthyroidism
  3. acromegaly (usually detected as diabetes mellitus)
  4. infiltrative disease (lymphoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are important rule outs with dilated cardiomyopathy (DCM) (3)

A
  1. dietary taurine deficiency (a risk with alternative diets)
  2. chronic tachycardia (arrhythmias) –> tachycardiomyopathy
  3. myocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the most common heart disease & cardiomyopathy in kitties

A

primary hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is primary hypertrophic cardiomyopathy inherited

A

in some cats in some breeds

autosomal dominant –> homozygous increases significance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the most common breeds that affect primary hypertrophic cardiomyopathy (7)

A
  1. maine coon & ragdoll breeds
  2. british shorthair
  3. bengal
  4. sphynx
  5. birman
  6. norwegian
  7. forest cat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does primary hypertrophic cardiomyopathy affect males vs. females

A

in male cats the disease occurs at an earlier age and is more severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how does the phenotype affect cats in primary hypertrophic cardiomyopathy

A

its very variable

not all have murmurs or clinical signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the pathophysiology of primary hypertrophic cardiomyopathy (5)

A
  1. concentric hypertrophy of LV
  2. poor relaxation
  3. diastolic failure
  4. LA enlargement –> thrombus, distal aorta (ATE), HQ pain & paresis
  5. left sided CHF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how is primary restrictive cardiomyopathy (RCM) diagnosed

A

based on histopathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the various phenotypes of primary hypertrophic cardiomyopathy

A
  1. endomyocardial & myocardial forms
  2. possible end stage HCM
  3. post inflammatory
  4. possible increased prevalence in Siamese
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the pathophysiologly of primary restrictive cardiomyopathy (RCM)

A

impaired diastolic filling consequent to fibrosis of the left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the echocardiographic features of primary restrictive cardiomyopathy (RCM) (3)

A
  1. severe atrial dilation
  2. walls normal thickness
  3. effusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is primary dilated cardiomyopathy (DCM)

A

dilated, poorly-contracting left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what breeds are predisposed to primary dilated cardiomyopathy (DCM)

A

no specific breeds (maybe oriental shorthairs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the causes of primary dilated cardiomyopathy (DCM)

A

genetic or viral origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what else may be the cause of primary dilated cardiomyopathy (DCM)

A

some (most?) cases may be end stage primary HCM/RCM (burnt out heart ex. through infarction & fibrosis, CHF or chronic tachycardia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

RA and RV enlargement with the RV wall thinning and aneurysmal bulges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC) (3)

A
  1. venticular tachycardia
  2. atrial fibrillation
  3. supraventricular tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the appearance of the left ventricle in arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

wall thickness and diameter of the LV are normal

26
Q

how is the systolic function in arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

normal or midly impaired

27
Q

what can be seen on PM in arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

myocardial fibrosis

atrophy in RV wall

28
Q

what is the etiology of arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

unknown

maybe familial in boxer dogs and humans

29
Q

what is the prognosis of arrhythmogenic right ventricular cardiomyopathy (ARVC)

A

poor due to right sided CHF and atrial thromboembolism (ATE)

30
Q

how is hypertrophic cadiomyopathy (HCM) classified

A

diffuse or regional increased LV wall thickness with a nondilated LV chamber

31
Q

how is restrictive cardiomyopathy the endocardial form classified

A

macroscopically by prominent endocardial scar that usually bridges interventricular septum and LV free wall

may cause fixed, mid-LV obstruction and often apical LV thinning or aneurysm

LA or bilateral enlargement is generally present

normal LV dimensions (including wall thickness) with LA or bilateral enlargement

32
Q

how is the myocardial form of restrictive cardiomyopathy (RCM) defined

A

normal LV dimensions (including wall thickness) with LA or biatrial enlargement

33
Q

how is arrythmogenic right ventricular cardiomyopathy (ARVC) defined

A

severe RA and RV dilation and often RV systolic dysfunction and RV wall thinning

the left heart may also be affected

arrhythmias and right sided congestive heart failure are common

34
Q

what is the risk stratification of cardiomyopathies

A

A predisposed: breeds mentioned

B1 (low risk) subclinical normal/mild atrial enlargement: older cats, male cats, loud murmur, familial history

B2 (higher risk) subclinical moderate severe/atrial enlargement: presence of gallop, presence of arrhythmia, moderate-severe LA dilation; poor LA function, extreme LV hypertrophy, LV systolic dysfunction, intracardiac thrombus or “smoke”, other echo abnormalities listed

C current/previous CHF/ATE

D: refractory CHF

35
Q

what histories do cardiomyopathies present with (8)

A
  1. asymptomatic
  2. dyspnea
  3. lameness
  4. paresis
  5. collapse
  6. inappetence
  7. lethargy
  8. ascites
36
Q

what are the clinical findings of cardiomyopathies (11)

A
  1. murmur
  2. hypothermia
  3. lameness/pain
  4. arrhythmia; bradycardia or tachycardia
  5. gallop sounds (audible S3/S4)
  6. dyspnea
  7. lung crackles (pulmonary edema)
  8. dullness on percussion of chest –> pleural effusion
  9. gotre if hyperthyroid
  10. retinal changes if hypertensive
  11. retinal changes if taurine deficient
37
Q

what might the murmur be from in cardiomyopathies (4)

A
  1. left outflow tract obstruction (hypertrophic obstructive cardiomyopathy (HOCM))
  2. right outlflow tract obstruction
  3. mitral valve insufficiency (distortion of anatomy of left or right ventricles)
  4. tricuspid valve insufficiency
38
Q

how do cardiomyopathies present on radiography (5)

A
  1. cardiac silhouette enlarged
  2. atrial dilation
  3. vascular congestion
  4. pulmonary edema
  5. +/- pleural effusion
39
Q

what ECG patterns can be seen with cardiomyopathies

A
  1. atrial fibrillation
  2. ventricular premature beat (ectopic)
  3. left anterior fascicular block (LAFB)
40
Q

what can echocardiography differentiate in cardiomyopathies

A

types of myocardial disease

but can’t differentiate primary from secondary

41
Q

how will hypertrophic cardiomyopathy look on echo (2)

A
  1. thickness of LV wall and interventricular septum

normal <5mm

abnormal >6mm (related to body weight)

  1. +/- LA dilation
42
Q

how is restrictive cardiomyopathy diagnosed on echo (4)

A
  1. wall thickness is normal: thickness of LV wall and interventricular septum <5mm
  2. left ventricle diameter is normal
  3. systolic function is normal
  4. severe atrial dilation (LA:Ao ratio)
43
Q

how does primary dilated cardiomyopathy appear on echo (4)

A
  1. poor systolic funciton: <30% fractional shortening
  2. dilated left ventricle: >12mm systole & >18mm diastole
  3. +/- dilated right ventricle: subjective
  4. wall thickness normal or decreased
44
Q

what are the echo findings of ARVC

A
  1. marked dilation of right ventricle and right atrium
45
Q

how are cardiomyopathies diagnosed using blood tests (5)

A
  1. renal funciton: chronic renal disease causes systemic arterial hypertension
  2. thyroid function (in older cats >7 years)
  3. taurine levels
  4. biomarkers (NT-proBNP, troponin)
  5. genetic tests
46
Q

how does NT-proBNP diagnose cardiomyopathies (3)

A
  1. can differentiate cardiac and resp diseases
  2. cannot differentiate types of myocardial disease
  3. can differentiate cats with myocardial disease without CHF and with CHF
47
Q

what genetic tests can be used for cardiomyopathies

A
  1. myosin binding protein C3 mutations can be present in Maine coon and ragdoll

but not all gene positive cats have evidence of disease

not all cats with evidence of disease are positive on the genetic test

48
Q

how are primary cardiomyopathies treated (5)

A
  1. diastolic dysfunction +/- outlfow tract obstruction (HOCM): reduce HR and contractility
  2. systolic dysfunction: increase contractility
  3. congestive heart failure
  4. arrhythmias
  5. aortic thromboembolism
49
Q

what are negative iontropes/negative chronotropes (2)

A

aim to improve diastolic function by agents weakening the force of muscular contractions

  1. calcium channel blocker (diltiazem)
  2. beta blocker (atenolol)
50
Q

what medications can reduce myocardial fibrosis

A

aim to improve diastolic function

  1. ACE inhibition
  2. spironolactone
51
Q

what is the function of digoxin

A

aim to improve systolic funciton

52
Q

what are the effects of digoxin

A
  1. improves contractility
  2. decreased heart rate
  3. used rarely & only for atrial fibrillation
53
Q

what is pimobendan used for

A

improve systolic function

54
Q

what are the effects of pimobendan (3)

A
  1. positive inotrope
  2. vasodilator
  3. imrpoves myocardial relaxation
55
Q

how are acute thromboembolisms managed (12)

A
  1. cage rest
  2. warmth
  3. analgesia: opioids
  4. +/- vasodilation (ACP): but can drop BP
  5. heparin (LMW)
  6. physiotherapy
  7. +/- low dose IV fluids
  8. +/- diuretics if in CHF
  9. +/- euthanasia
  10. surgery
  11. streptokinase
  12. tissue plasminogen activator
56
Q

how are thromboembolisms measured

A
  1. clopidogrel
  2. aspirin
  3. low molecular weight heparin
  4. rivaroxaban: direct inhibition of activated factor X (factor Xa) being trialled vs. clopidogrel
57
Q

how is hyperthyroidism treated as a cause of HCM (4)

A
  1. treat hyperthyroidism (medical, surgery, radioactive iodine, dietary Y/D)
  2. treat hypertension if present
  3. tachycardia if present: atenolol
  4. treat CHF if present: diuretics +/- ACE inhibotrs
58
Q

how is systemic hypertension treated as a cause of HCM (4)

A
  1. treat cause if known (hyperthyroidism, chronic renal failure, hyperaldosteronism)
  2. treat with amlodipine +/- ACE inhibitor
  3. eliminate salty treats
  4. furosemide and ACE inhibition
59
Q

what is hypertensive BP in cats

A

>160 mmHg systolic

60
Q

how is secondary DCM treated when there is taurine deficiency (4)

A
  1. change diet
  2. supplement with taurine
  3. treat CHF if present with furosemide and ACE inihibtor
  4. pimobendan if needed (off license)
61
Q

how should cats be monitored (3)

A
  1. renal function and electrolytes be monitored frequently
  2. drug doses checked freq
  3. owners should be educated to monitor resp rate and character (lameness/pain)

Module 15 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions