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ZUKU NAVLE PREP > Canine Flash Notes - Cardiology Review > Flashcards

Canine Flash Notes - Cardiology Review Flashcards

1
Q

what are some examples of valvular diseases in dogs?

A

endocardiosis, congenital aortic stenosis, congenital pulmonic stenosis, congenital av valve dysplasia, bacterial endocarditis, av valvular regurgitation due to cardiomegaly

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2
Q

what is S1?

A

heart sound one, lub - closure of the AV valves (start of ventricular systole)

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3
Q

what is S2?

A

second heart sound, dub - closure of semilunar valves (aortic & pulmonic valves) start of ventricular diastole

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4
Q

what is the most common cause of a split S2 sound?

A

heartworm disease - due to delayed closure of a semilunar (aortic or pulmonic) valve

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5
Q

T/F: S2 may be absent in arrhythmias if the ventricles do not fill adequately (semi lunar valves don’t open)

A

true

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6
Q

what is the difference between the stenosis & regurgitation?

A

stenosis - obstruction of flow, usually congenital

regurgitation (insufficiency) - incomplete closure of valve, either congenital or acquired

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7
Q

what is the purpose of the left & right av valves?

A

prevent back flow of blood into the atria during ventricular systole

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8
Q

what is the purpose of the pulmonic & aortic semi-lunar valves?

A

prevent back flow of blood into ventricles during ventricular diastole

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9
Q

what is the hallmark of valvular disease in dogs?

A

murmurs - due to turbulent blood flow over the valve

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10
Q

T/F: severity of disease & severity of murmur are not correlated but progression of a murmur does indicate a progression of disease

A

true

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11
Q

what are some examples of causes of low grade murmurs with no other signs of cardiac disease?

A

anemia, fever, anxiety, kittens/puppies under 6 months old, hypoproteinemia, & athletic heart

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12
Q

what are some murmurs that should be worked up with ECG, rads, & echo?

A

murmur with clinical signs of cardiac disease

continuous or diastolic murmur

gallop rhythm

pulse deficits

progression of murmur

murmur when anesthesia is contemplated due to increased risk (grades 2-6, check for cardiac disease)

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13
Q

what are the different grades of murmurs?

A

1 - very soft, minutes to hear in a quiet room

2 - soft murmur but definite

3 - moderate

4 - loud, no precordial thrill

5 - loud with palpable precordial thrill

6 - loud, precordial thrill & heard with the stethoscope off of the chest wall

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14
Q

what are examples of pathologic systolic murmurs? diastolic murmurs? continuous murmur?

A

overall - stenosis, regurgitation, & shunts

systolic - left av valve regurgitation, aortic stenosis, pulmonic stenosis, right av valve regurgitation, & VSD

diastolic - aortic valve regurgitation

continuous - PDA

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15
Q

T/F: atrial septal defects, pulmonic regurgitation, & tetralogy of fallot are rare causes of murmurs

A

true

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16
Q

what are radiographic findings seen with right atrial enlargement?

A

lateral view - elevation of trachea at carina, loss of cranial waist

DV view - 9 to 11 o’clock bukge

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17
Q

what are radiographic findings seen with left atrial enlargement?

A

lateral - elevated trachea & carina, separation of mainstem bronchi (left above right)

DV view - 2 to 3 o’clock bulge (auricle), cowboy legs (spread mainstem bronchi)

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18
Q

what are radiographic findings seen with right ventricular enlargement?

A

lateral - 6 to 9 o’clock bulge, more sternal contact, trachea & carina elevation, & apex elevated off of sternum

DV view - 6 to 9 o’clock bulge (backwards or reverse D) & apex shifted more to the left

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19
Q

what are radiographic findings seen with left ventricular enlargement?

A

lateral - loss of caudal waist, 3 to 6 o’clock bulge

DV view - rounding at 3 to 5 o’clock & apex shifted right

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20
Q

what are causes of an enlarged aortic arch seen on rads? what is seen?

A

PDA, aortic stenosis, & aortic aneurysm

lateral - elongated cardiac silhouette, protrusion of cranial heart border at 11 to 1 o’clock

DV view - widened aortic arch at 11 to 1 o’clock

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21
Q

what are causes of an enlarged MPA seen on rads? what is seen?

A

pulmonic stenosis, HWD, PDA, septal defects with left to right shunting (VSD, ASD)

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22
Q

what is the main cause of pulmonary edema in dogs?

A

usually caused by left sided congestive heart failure - fluids back up into the pulmonic circulation

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23
Q

what are the 2 types of pulmonary edema? how are they differentiated on rads?

A

interstitial edema - fluid in lung tissue, vessels are fuzzy but evident, more opaque lung field (linear or nodular, greater in perihilar area) & air still evident in lungs

alveolar edema - alveoli are filled with fluid, opaque lung field, no air in lungs, air bronchograms, & no vasculature seen

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24
Q

what are the radiographic findings of overcirculation? what are some of the main causes? what are the differentials you should consider?

A

arteries larger than veins & more opaque lungs

HWD, PDA, left to right shunts (VSD, ASD), CHF, & fluid overload

ddx - expiratory rad or underexposure

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25
Q

what are the radiographic findings of undercirculation? what are some of the main causes? what are the differentials you should consider?

A

more radiolucent lungs, arteries smaller than veins

causes - right to left shunt, pulmonic stenosis, hypovolemic shock, adrenal insufficiency

ddx - emphysema, over-inflation, & overexposure

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26
Q

what are the main differentials to consider for pleural effusions?

A

hydrothorax, ascites, right sided CHF, right av tricuspid regurgitation, pulmonic stenosis, HWD, pericardial effusion/pericarditis, tetralogy of fallot, uremia, hypoproteinemia, & fluid overload

other pleural effusions - pyothorax, hemothorax, chylothorax, neoplasia, & pleuritis

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27
Q

what are the main cardiac differentials to consider for pulmonary edema?

A

cardiogenic edema with visible cardiomegaly - left sided CHF, chronic MVD, cardiomyopathy, ruptured chordae tendinae

cardiogenic edema without cardiomegaly - electrical shock, trauma, cardiomyopathy in some cases, tachyarrhythmia, & myocardial depressants

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28
Q

what are some causes of non-cardiogenic pulmonary edema?

A

infection, toxin, allergy, drowning event, venous obstruction, hypoalbuminemia

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29
Q

what are some causes of increased tissue density often mistaken for pulmonary edema?

A

interstitial fibrosis, interstitial pneumonia, atelectasis, allergic conditions, & lungworms

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30
Q

what is seen on radiographs in a dog with pleural effusion?

A

lat - increased opacity in ventral thorax & scalloped appearance due to fluid in tissues

DV view - retraction of lungs from thoracic wall, blunting of costophrenic angles, widening of mediastinum, scalloped appearance, & blurring/disappearance of cardiac silhouette

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31
Q

if you see ascites & hepatomegaly in an animal on rads, what do you suspect?

A

right sided heart failure - fluid back up into the body (systemic veins)

32
Q

what is m-mode for echos? what is it used for? what does it requires?

A

ice pick images of the heart that gives lines for ventricles, left atria, aorta, valves

requires viewing movement of the heart over time

uses - measures cardiac wall thickness, chamber size, cardiac contractility (fractional shortening), & valves in motion

33
Q

what is the purpose of using doppler on a cardiac ultrasound?

A

compares the frequency of transmitted ultrasound with received US of moving cells (blood cells), cells moving towards the transducer have a higher frequency than those moving away

used to estimate velocity of blood flow

34
Q

what does a p-wave indicate on an ecg?

A

atrial depolarization

35
Q

what does the p-r interval indicate on an ecg?

A

delay of impulse through AV node & bundle of his

36
Q

what does the qrs complex indicate on an ecg?

A

ventricular depolarization

37
Q

what does a q-wave indicate on an ecg?

A

depolarization of septum

38
Q

what does a r-wave indicate on an ecg?

A

depolarization of left ventricle

39
Q

what does a s-wave indicate on an ecg?

A

depolarization of right ventricle

40
Q

what does a s-t segment indicate on an ecg?

A

interval of ventricular systole

41
Q

what does a q-t segment indicate on an ecg?

A

ventricular depolarization & repolarization

42
Q

what does a t-wave indicate on an ecg?

A

repolarization of ventricles

43
Q

what are the goals in heart failure management?

A
  1. maintain or increase cardiac output
  2. minimize myocardial oxygen demand
  3. reduce activity & anxiety
  4. relieve fluid accumulation (edema)
  5. control rhythm disturbances
44
Q

what are examples of bradycardic arrhythmias?

A

sinus bradycardia, atrial/sinoatrial standstill, sick sinus syndrome, 1st degree av block, 2nd degree av block, 3rd degree av block, junctional rhythm, & branch blocks

45
Q

what are examples of tachycardic arrhythmias?

A

atrial tachycardia, atrial fibrillation, junctional tachycardia, ventricular tachycardia, ventricular fibrillation, & cardiac arrest

46
Q

what treatment is used for heart disease & heart failure?

A

rest + O2 + diuretics + digoxin + anti-arrhythmics

47
Q

what medication should not be given to animals with HCM? what do you give them instead?

A

digoxin - not a contractility problem

diltiazem - cause relaxation to increase ventricular filling

48
Q

what are some surgical heart diseases?

A

PDA, PPDH, PS, & large septal defects

49
Q

what are some ecg findings from animals with congenital cardiac defects?

A

atrial enlargement - big p wave

left ventricular enlargement - tall wave

right ventricular hypertrophy - right axis deviation

widened QRS

50
Q

what are the most common congenital cardiac defects in dogs & cats?

A

dogs - PDA

cats - av valvular dysplasia

51
Q

what rhythm is seen on this ecg strip?

A

sinus bradycardia, HR <70 for a dog & <90 for a cat

52
Q

what rhythm is seen on this ecg strip?

A

sinoatrial block (arrest) - pause of 2 or more r-r intervals, clinically insignificant

53
Q

what rhythm is seen on this ecg strip?

A

mobitz type I 2nd degree av block

p-r prolongs until a QRS is dropped

54
Q

what rhythm is seen on this ecg strip?

A

dropped QRSs (bigeminy or trigeminy) but p-r intervals are constant

55
Q

what rhythm is seen on this ecg strip?

A

atrial standstill (hyperkalemia) - no p waves

56
Q

what rhythm is seen on this ecg strip?

A

1st degree av block, long p-r interval, delayed conduction impulse through av node to ventricle, dogs > 0.14 sec & cats > 0.05 sec

57
Q

what rhythm is seen on this ecg strip?

A

sinus tachycardia - normal ecg just fast rate

58
Q

what rhythm is seen on this ecg strip?

A

atrial APCs - premature P-QRS-T with a pause

59
Q

what rhythm is seen on this ecg strip?

A

paroxysmal atrial tachycardia - fast HR & 3 or more APCs

60
Q

what rhythm is seen on this ecg strip?

A

atrial flutter - no p waves, coarse f waves

61
Q

what rhythm is seen on this ecg strip?

A

atrial fibrillation - fine f waves, rapid, irregularly regular ventricular rate

62
Q

what rhythm is seen on this ecg strip?

A

junctional (av node - his purkinje) premature contractions - negative p waves, digitalis toxicity

63
Q

what rhythm is seen on this ecg strip?

A

junctional rhythm - fast or slow JPCs, negative p waves, spontaneously reverts to bradycardia or tachycardia

64
Q

what rhythm is seen on this ecg strip?

A

ventricular premature contractions - QRS is wide & bizarre

65
Q

what rhythm is seen on this ecg strip?

A

ventricular tachycardia - 4 or more VPCs in a row

66
Q

what rhythm is seen on this ecg strip?

A

ventricular fibrillation - continuous chaotic bizarre positive & negative oscillations, medical emergency, needs CPR

67
Q

what conduction disorder is shown on this wave form?

A

intraventricular conduction blocks - QRS is prolonged, microscopic intraventricular myocardial infarct

68
Q

what conduction disorder is shown on this wave form?

A

pre-excitation syndromes - QRS widened with notched r’s delta waves, re-entrant impulses

69
Q

what conduction disorder is shown on this wave form?

A

sick sinus syndrome - bradycardia pattern seen often in female mini schnauzers, weakness & syncope

70
Q

what are your differentials for slow, regular rhythms?

A

sinus bradycardia, complete AV block (ventricular escape rhythm), & atrial standstill (ventricular escape rhythm)

71
Q

what are your differentials for slow, irregular rhythms?

A

sinus block/arrest, sick sinus syndrome, & 2nd degree av block

72
Q

what are your differentials for fast, regular rhythms?

A

sustained ventricular tachycardia, atrial tachycardia, & sinus tachycardia

73
Q

what are your differentials for fast, irregular rhythms?

A

APCs, paroxysmal atrial tachycardia, atrial flutter/fibrillation, VPCs, & paroxysmal ventricular tachycardia

74
Q

what are the 4 main groups of drugs used to treat arrhythmias?

A
  1. sodium channel blockers - decreases conduction, use on ventricular arrhythmias
  2. beta blockers - decrease sympathetic tone, for supraventricular & ventricular arrhythmias
  3. potassium channel blockers - supraventricular tachycardia
  4. calcium channel blockers - atrial fibrillation, cardiac disease, & bradycardia
75
Q

what rhythm seen on ecg precedes cardiac arrest?

A

ventricular fibrillation

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