Arrhythmias and Dumps Flashcards
Maintenance treatment of SPDs
Sotalol/Diltiazem
What can you use to help bring down K levels in the blood?
Bicarb, glucose and Ca gluconate
No PR changes before QRS dropped
2nd Degree AV block
Mobitz Type II
Worse prognosis, needs pacemaker
An arrhythmia that has a normal P-R interval but then suddenly the QRS drops.
This one is going to need a pacemaker stat!
2nd degree AV block
Mobitz Type II
Normal P-R interval then drop of QRS
Bad prognosis
Delay or failure of transmission at the AV node
AV Block
Spontaneous ventricular depolarization at 60-180 bpm.
Asymptomatic but keep watching because ventricular tachycardia may be coming.
Accelerated idioventricular rhythm/ idioventricular tachycardia
In an animal with an enlarged left atrium, what would the P waves look like?
Wide P waves
QRS premature and NO P wave
Wide and Bizzare
Very Common in Vet Med: Boxers and Dobermans
Ventricular Premature Depolarizations
P waves occur same time as T waves
Supraventricular Premature Depolarizations
PR interval increases until QRS dropped
Second Degree AV Block
Mobitz Type I
Failure of the SA node for 1 or more beats
If occurs for more than 6 seconds, signs occur
Sinus Arrest
I am an arrhythmia and if you see me in cats I am NOT normal.
My R-R interval varies and I am caused by increased vagal tone or I can show up in eye or abdominal surgeries.
In other species you dont even have to treat me. Who am I?
Sinus Arrhythmia
P for every QRS but R-R varies
Sinus Arrhythmia
Sinus Arrest
What is this?
60 Hz Interference
Hyperkalemia
Prolonged P-R interval
Caused by vagal tones and drugs(Digoxin)
1st Degree AV Block
VPDs Triplets
ER treatment of VPDs
Lidocaine
No AV conduction, P waves and escape beats, Low heart rate.
3rd Degree AV Block
Name 3 arrhytmias that have no P wave
Hyperkalemia
VPDs
Atrial Fibrillation
I am an arrythmia that you might want to put a Holter monitor on.
I have normal QRS but then I get tired and do nothing for a few seconds.
If I keep being lazy you should probaly have someone else do the job. Mr. Pacemaker is good.
Sinus Arrest
P waves change in height.
Varibale P-R interval
Clinically silent. Can only see in EKG.
Wandering Atrial Pacemaker
Wandering Atrial Pacemaker
Sinus Arrhytmia
Atrial Flutter
Happens about ~1 day-1 week before Atrial Fibrillation
Variable P, Normal QRS seen in boxers with heart disease such as cardiomyopathy
SPD’s
Boxer cardiomyopathy, Doberman w/ DCM, Aortic stenosis and Hypertrophic cardiomyopathy all cause _____ on a EKG.
VPDs
I can be diagnosed upon physical examination.
I got No P waves and random R-R internals.
Treated with Digoxin and Diltiazem
I can be confused with 60 Hz Interference.
Atrial Fibrillation
No P waves
Normal QRS
R-R random
Atrial Fibrillation
> 3 VPDs @ 160-180 bpm for 30 seconds
Ventricular Tachycardia
Increased heart rate > 160-180/240 pbm
Normal P QRS T
Sinus Tachycardia
T/F: Sinus arrhythmias are NOT normal in cats
TRUE
First Degreen AV Block
Abnormal sinus node and AV system. - sinus brady cardia, sinus arrest/ AV block and tachycardia
Sick Sinus Syndrome
Bigeminy
Name two arrthymias with a prolonged QRS
Hyperkalemia
VPDs
Sinus Bradycardia
I am an arrhythmia that that when my P-R intervals start to increase my QRS goes away :(
But my brother’s P-R interval never changes it stays normal and then the QRS goes away.
2nd degree AV Block
Mobitz Type I
P-R Interval increase THEN drop of QRS
Ventricular Fibrillation
I am arrhythmia that can be caused by drugs and fibrosis and infection of the heart.
My rhythm is nice and slow.
To get rid of me you are going to have to remove the cause the maybe even put in a pacemaker.
Who am I?
Sinus Bradycardia
I have can have random QRS complexes that occur at a slow pace.
A pacemaker would fix me right up and increase the pets survival time over 6 months.
3rd degree AV Block
Emergency treatment for SPDs
Esmolol/ Diltiazem
My rhythm strip shows the R on T phenomenon caused by HCM.
I have a really wide QRS with no P wave.
10% of heart beats are me :)
VPDs
Very Common
In an animal with right atrial enlargement. What would the P waves look like?
Tall.
Increase in amplitude
I cause an arrhythmia that can be prevented with Ca Gluconate.
Renal failiure, ATE, and Addison’s cause me.
I move nice and slow(bradycardia).
My T waves are tall and I have NO P waves.
My QRS are wide.
You can find me twitching but no cardiac output.
Hyperkalemia
I have an irregular and disorganized ventricular activity.
You can treat me with Shock, Epi and CPR.
You can also see the R on T thing.
Ventricular Fibrillation
Occurs after a pause/ delay with NO P wave
Ventricular Escape Beats
High heart rate, R on T, and too many
VPDs
If I have 300 bpm for 6-8 seconds and I look like this….
What Am I?
Venticular Tachycardia
Treatment of Sinus Bradycardia
- Remove the cause
- Do atropine or glycopyrrolate test: + vagal problems , - pacemaker
I am an arrythmia that goes away when you get the animal excited.
I am caused by increased vagal tone and my P waves are variable in height and shape
Wandering Atrial Pacemaker
Arrhythmias with proloned QRS
Left Bundle Branch Block
Right Bundle Branch Block
VPD
Ventricular Escape Beat
What is most likely to cause tachycardia?
Atrial Fibrillation
Dump: A 5 yo Irish wolfhound presents with decreased contractility, atrial fibrillation, and ventricular repsonse rate of 280 bpm. What drugs do you give?
Digoxin and Diliatizem
Dump: What is the best way to detect pulmonary edema from congestive heart failure?
Radiographs.
Dump: What can be arrhythmia can be diagnosed on the physical exam?
Atrial Fibrillation
Dump: T/F You can always hear crackles in the bronchi with pulmonary edema.
FALSE
Dump: Which congenital heart disease has continuous/machinary murmurs?
PDA
Dump: What would be the inital treatment for a dog with MILD heart failure due to DCM?
Furosemide and Pimobendan
Because you want to be able to treat at home b/c its mild.
Oxygen added when it gets severe.
Dump: Prune, a 9yo King Charles Spaniel, come in with a cough and a grade III/V murmur over mitral valve. The owner can only afford 2 tests. What should they be?
Echocardiogram(ULS) and Radiographs
Radiographs to see the ruptured chords and enlarged left atrium.
Dump: Dyspnea and hind limb paralysis are signs for which cardiomyopathy?
HCM in cats
Dump: Is it true that HCM can remain subclinical for years?
YES it is true.
Dump: What is used to diagnose the severity of an aortic stenosis?
Doppler
Dump: In which cardio disease can an enlarged left atria exaggerate the cough caused by chronic airway disease?
Endocardiosis
Dump: What is the standard treatment for endocardiosis?
Ace inhibitor, Pimobenden and Lasix
Dump: What arrhythmia can DCM in Dobermans cause?
VPDs
Volume overload is caused by what kind of hypertrophy?
Eccentric
Dump: HCM causes what kind of hypertrophy?
Concentric Hypertrophy
Increased cells, reduced chamber size= regurg
Dump: What kind of hypertrophy would we see in Myxomatous disease?
Eccentric
Volume overload
Dump: Dyspnea, cough, tachycardia, weak pulse, weakness and syncope are all signs of what kind of CHF?
Left sided CHF
Dump: What is the best/most likely treatment of Grade III Av Block?
Pacemaker
Because it is a complete block.
Dump: You treated a 9yo SF Toy Poodle for left sided congestive heart failure due to myxomatous valve disease and then sent her home. A week later it experiences weakness and starts vomiting. You do a blood panel and the BUN and CREA were increased. What do you do?
Decrease the furosemide dose because no filtrate going through the kidneys
Dump: What is the best way to diagnose a HCM?
Echocardiogram
Dump: ARVC in boxers is best treated with what?
Sotalol
B-blockers treat arrhythmias.
Tell me the truth… is it harder to detect heart worms in cats?
Yup
An owner forget to give his dog prevention for 3 months. What advice could you give the owner?
Begin giving preventive and rely on the “reach back effect
Which prophalixis treatments kill all L3 and L4 for up to 1 month?
Ivermectin, Selemectin and Milbemycin
Treatment for cardiac tamponade
Immediate pericardiocentesis
Ataxia
the loss of full control of bodily movements
What should you not do in the treatment of thoracolumbar injury?
Do not give prednisolone, do cage rest
T/F Flexor withdrawl cannot occur without conscious brain perception.
TRUE
What can exacerbate intervertebral disk disease?
Exercise / Trauma
Which of the following will you NOT see with a C6-T2 lesions?
LMN bladder
Horners Syndrome
Absent paniculus
LMN front limbs
You will not see a LMN bladder you will see an UMN bladder
German Sheapard
Bright and alert, tetraplegia, hypotonia, normal crain nerves, superficial and deep pain present.
Wobblers disease
Increased extensor tone(UMN), head tilt, circling and falling to right side, CP and CN deficits on the left side.
Right cerebral tumor
Left cerebral tumor
Right brain stem tumor
Left brain stem tumor
Left cerebral tumor
Cross extensor is caused by LMN or UMN ?
UMN
Dog comes in dragging his back legs. Paraplegia, hypotonicity, and superficia pain is absent. Where is the lesion.
Caudal to L3
LMN pelvic limbs
A dog present with vestibular signs, CP deficits all on the same side. Where is the lesion.
The lesion is on the same side as the signs in the brainstem
5 year old German Shepard
Difficulty risingm avoiding stairs, pain over lumbosacral area, mild parapersis, patellar relex exaggerated, poor flexion of hock and stifle, reduced crainial tibial and perineal refelxes. Reduced superficial pain in hind lumbs.
Where is the lesion?
L7/SI
Masticatory Myostitis will respond well to what kind of therapy?
Steroids
Is fibrocartigenous emboli painful or not?
NOT painful
