Brainscape's Knowledge GenomeTM

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


See full index

Small Animal Cardiology > Cardiac Disease > Flashcards

Cardiac Disease Flashcards

1
Q

What clinical signs and echo findings would you see in a cause of heart worm?

A

Echo- pulmonary hypertension + pulmonary thromboembolism

End result and signs - right sided congestive heart failure +
pericardial effusion

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

What is the most common cardiac disease?

A

Degenerative mitral valve disease

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

What is the aetiology and signalment in mitral valve dysplasia?

A

Mitral valve leaflets are too short
Papillary muscles don’t work

Congenital - seen in young large breed dogs

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

What is the aetiology and signalment of MDVD?

A

Older small breed dogs
CKCS
Idiopathic nodular thickening of the mitral valve leaflets

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

What are the haemodynamic effects of MDVD?

A

Reduced afterload
Increased preload
Reduced stroke volume
Volume overload of the left side of the heart
= eccentric hypertrophy and dilation of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the clinical presentation in MDVD?

A

Grade 1-6, left apical, pan or holo, early sytolic, plateau murmur
+/- palpable thrill

Coughing at night 
Tachypnoea / dysponea
Tachycardia
Slow CRT 
History of lethargy and exercise intolerance 
Pulmonary crackles

May be a symptomatic

ALWAY REMEMBER TO SIMULTANEOUSLY AUSCULTATE AND PALPATE PULSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What blood pressure can you expect in MDVD?

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What ECG abnormalities might you see with MDVD?

A

Supra ventricular premature complexes
Atrial fibrillation
Ventricular premature complexes

(Not VTach, seen in DCM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should you sedate a dog in heart failure with?

A

Butorphanol and alfaxalan top ups

Avoid alpha 2 agonists - cause a reflex bradycardia - massively drop cardiac output

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

How can you confirm MDVD?

A

Echocardiography

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

What findings will you see on echo in MDVD?

A 
Enlarged left atrium and ventricle
Mitral valve regurgitation 
Rounded left ventricle
Hyper dynamic systolic function
Poor contractility
Pulmonary hypertension
Tricuspid regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can you measure systolic function in MDVD?

A 
Fractional shortening - contractility
Ejection fraction - stroke volume
E point septal separation - contractility
End systolic volume index
Systolic time intervals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can you differentiate MDVD from DCM?

A

MDVD - left atrium is bigger than the left ventricle, wall is normal thickness

DCM - both the left atrium and ventricle are dilated, thin wall

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

What clinical pathology results will you see in MDVD?

A

Pre-renal azotaemia

Elevated cardiac troponin, pro-BNP and pro-ANP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can you diagnose MDVD in the pre-clinical phase?

A

Murmur

Holter monitor - VPCs or atrial fibrillation

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

What is the prognosis of MDVD in the CKCS compared to large breeds?

A

Better for CKCS - can survive 12m with CHF if well controlled
Poorer for large dogs, deteriorate rapidly

Larger ventricles and atria are poor prognostic indicators, along with ruptured chordae and high pro-BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the aetiology of endocarditis?

A

Infection of 1 or more of the endocardium surfaces
- mitral and aortic valves most common

Streps, staphs, e.coli, pseudomonas, bartonella

Bacteriaemia occurs (IV catheter, dental disease)
Multiple emboli - concurrent plolyarthrits, glomerulonephritis, neuro
Bacteria adhere to damage enocardium (eg subaortic stenosis)
Aided by a hyper coagulate state

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

How does endocarditis present?

A

New murmur
Diastolic murmur
PUO - classic presentation

Arrhythmias, myocardial infarction, signs of CHF
Medium to large breeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can you diagnose endocarditis?

A

Haematology and biochemistry
Blood culture
Echocardiography - valvular vegetations, regurgitation, systolic dysfunction

Major criteria

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

What are the major criteria for defining endocarditis?

A

Positive echocardiogram
- vegetative, oscillating lesions, erosive lesions, abscess

New valvular insufficiency / diastolic murmur

Positive blood culture - 2 positive cultures

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

How should you treat endocarditis?

A

IV antibiotics for 1-6w
Fluoroquinolones + metronidazole + potentiated amoxicillin

C-reactive proteins
Anticoagulants

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

What is the prognosis for endocarditis?

A

Guarded - recurrent problems and CHF possible

Irreversible valvular damage

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

What types of primary cardiomyopathy are there?

A

Dilated cardiomyopathy
Arrthymogenic right ventricular cardiomyopathy
Hypertrophic cardiomyopathy - rare in dogs, terriers, pointer
- 2ndry to left ventricular outflow tract obstruction
Atrial cardiomyopathy - springers, Labrador
- atrial walls thin leading to atrial standstill

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

What secondary cardiomyopathies occur?

A

Myocarditis - viral, automimmnue, infectious, traumatic
Tachycardiomyopathy - most common
- seen with AF, VTach and SVTach

Other causes 
Nutritional - taurine or l-carnitine deficiency
Systemic hypertension 
Drugs and toxins 
Metabolic and endocrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the aetiology and signalment of DCM?

A

= impaired systolic function + dilated cardiac chambers

Seen in middle aged medium to large breed dogs
Idiopathic but likely to be genetic

Dilation of all 4 chambers and increased heart to body weight ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most common cardiomyopathy in dogs?

A

DCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the cardiac decompensation in DCM?

A

Dilation of the AV value annulus = mitral regurgitation
Fibrosis and arrhythmias due to cardiac remodelling
Increased hydrostatic pressure = congestion
Toxicity to myocyte a due to sympathetic drive

28
Q

How does DCM present in the Doberman?

A

Slowly progressive
Inherited
Ventricular arrhythmias and sudden death
Cardiomegaly
Screening recommended every 4 months - short survival after development of CHF

29
Q

What is the aetiology and signalment seen with arrhythmogenic right ventricular cardiomyopathy?

A

= loss of cardiac myocytes, replaced with fibro-fatty tissue

Boxers

30
Q

What is the clinical presentation of ARVC?

A

Asymptomatic with VPCs
Symptomatic with VPCs
Ventricular dilatation, myocardial dysfunction and dysrrthymias

May present as sudden death
May also present as syncope and exercise intolerance
Cough, tachypnoea, dysponea, abdominal distension, increased water intake, heart murmur

31
Q

What presentation would you expect in a dog with DCM?

A

Large breed or cocker spaniel

Grade 1-3 systolic heart murmur, some dogs have none
Gallop sound

Adult dog with a history of collapse

32
Q

What would you find on the rest of your clinical exam in a case of DCM?

A 
Cardiac cachexia
Pale mm and slow CRT
Tahcyponea, dysponea
Weak femoral pulses
Chest percussion - pleural effusion
Jugular distension
Abdominal effusion 
Respiratory crackles
33
Q

What are the two presentations of DCM?

A

Preclinical - sudden death and ventricular arrhythmias

Clinical - forwards and backwards heart failure

34
Q

What arrhythmias are seen with DCM?

A

AF
SVTach
VTach
VPCs

35
Q

What is the definitive diagnosis of DCM?

A

Echocardiography
Left and right sided chamber enlargement
Thin walls
Reduced contractility and systolic function
Mild to moderate mitral valve regurgitation

36
Q

How many VPC on a holster monitor in 24h would make you suspicious of cardiomyopathy?

A

Doberman - more than 50 VPCs
Boxer - 100-300 VPCs

Likely affected 300-1000
Affected greater than 1000

37
Q

What drug is indicated in pre-clinical DCM?

A

Pimobendan

+/- Benazepril - used in people

38
Q

What conditions should you consider treating in DCM?

A 
Supraventricular tachycardia
Ventricular tachycardia
Pulmonary hypertension 
Preclinical disease
Congestive heart failure
39
Q

What is the prognosis for DCM?

A

Better with cocker spaniels with taurine deficiency, especially if over two - contractility improves after taurine supplementation

Dobermanns can live 2-4y with preclinical DCM
Survival only around 4m after development of CHF

40
Q

What are common causes of a secondary myopathies in cats?

A

Hypertension

Hyperthyroidism

41
Q

How should you investigate hypertension in a cat?

A

Haematology and biochemistry
Total T4
Urinalysis

42
Q

What complications can hypertension cause?

A

Retinal detachment
Neurological problems
Renal damage

43
Q

What is the pathology and presentation in feline HCM?

A

Marked concentric hypertrophy of the left ventricle = reduced diastolic function & reduced compliance

Present as sudden death, sleeping more or dysponeic

Persians, Maine coons, ragdoll, Norwegian forest cat

44
Q

What other diseases must you rule out to make a diagnosis or hypertrophic cardiomyopathy?

A 
Aortic stenosis
Systemic hypertension
Hyperthyroidism 
Chronic renal failure
Acromegaly
Diabetes mellitus
45
Q

What diagnostic signs will you see on echo in a cat with HCM?

A

Thickened left ventricular wall and septum
= more than 1/3 of chamber diameter
Enlarged papillary muscles
Bulging left atrium
Smoke in the the left atrial appendage
SAM of MV
Mild mitral valve regurgitation (exacerbates hypertrophy)

46
Q

What are the radiographic signs of HCM?

A

Cardiomegaly
Enlarged left atrium

DV - typical valentines heart - left side of the heart is pushing the atrial septum over to the right

Signs of CHF - patchy alveolar pattern seen in cats with CHF
(Less predictable distribution)
Congested pulmonary veins

47
Q

What signs might you see on electrocardiography in HCM?

A

Left fasicular bundle branch block
Atrial fibrillation
Left ventricular enlargement - tall T waves

48
Q

What produces the murmur in HCM?

A

Atrial septum bulge obstructs the LVOT
= high ventricular outflow tract velocity and biphasic acceleration
SAM of the mitral valve

49
Q

What kind of murmur is produced in HCM?

A

Diastolic, Gallop murmur - hear S3 and S4

Harsh murmur

50
Q

What are the two presentations of HCM?

A

Asymptomatic but have a murmur

Left sided congestive heart fairlure

51
Q

How does a cat with FATE present?

A

Extreme pain - methadone ASAP!!
Paraplegic
Hypothermia of the limbs
Blue nail beds

  • due to thrombus at the aortic bifurcation – external iliac arteries
52
Q

How should you treat clinical HCM and CHF?

A

Furosemide IV - venodilator and reduces blood volume (preload)
Benazepril - ace inhibitor (licensed for renal disease)
Per untold - venodilators
Prevent thromboembolism - clopidogrel

Furosemide and enalapril have been proven to reduce the risk of an adverse outcome in cats with CHF due to HCM

53
Q

How can you treat preclinical HCM?

A

Beta blockers - Propanolol, emsomolol

  • reduce LVOT and SAM
  • slows heart rate and improves diastolic function
  • CI in CHF

Pimobendan - Ca channel blocker
Benazepril - ace inhibitor
Diltiazem - positive lusiotrope = improves diastolic filling

There is no evidence that any drug slows down the progression to CHF

54
Q

How does DCM usually present in cats and what must you rule out?

A

Usually collapse and in cardiogenic shock

Must rule out taurine deficiency as a cause - supplement

55
Q

How should you manage DCM due to taurine deficiency in cats?

A 
Taurine
Pimobendan
Benazepril 
Furosemide 
Digoxin

O2 therapy
Warmth
Drain the pleural effusion

56
Q

What are the two forms of restrictive myopathy seen in cats?

A

Endomyocardial - large atrium and bridging scars
Unclassified - has features of different types of cardiomyopathy

Usually have normal ventricular wall measurements, chamber size and function
However the left atrium is dilated and diastolic is reduced due to restrictive pathology

57
Q

How does ARVC usually present in cats?

A

Ventricular arrhythmias and right sided congestive heart failure

58
Q

What are the consequences of HCM?

A

Left sided congestive heart failure
FATE
Hypertension
Arrhythmias

59
Q

What does increased pro BNP suggest?

A

Ventricular stretch

60
Q

What does increased cardiac troponin I suggest?

A

Ischaemic episode, neoplasia, myocarditis

= damage to myocardium

61
Q

When should you recommend a cardiology work up to an owner?

A

Grade 3+ mitral valve regurgitation

Grade 4+ mitral valve regurgitation

62
Q

How should you work up a dysponeic patient with a history of MDVD?

A

Auscultate - determine progression of murmur
Palpate pulses, CRT mm colour
Give oxygen
Sedate with butorphanol for thoracic radiographs
T fast scan to check for pericardial effusion
Give IV furosemide after ruling out pericardial effusion
Take baseline bloods

63
Q

How should you work up a MDVD with a chaotic heart rhythm no is collapsed?

A

ECG
Oxygen
T fast to rule out pleural / pericardial effusion
IV furosemide

64
Q

What underlying conditions lead to VPCs and ventricular tachycardia, therefore must be treated first?

A 
CHF - myocardial hypoxia  and ischaemia
Catecholamines - stress and pain
Hypokalaemia
Acidosis
Abdominal disease
- GDV
- pancreatitis 
- splenic lesions
- pyometra
- sepsis 
- perforated GI ulcer
65
Q

What underlying factors do you need to identify and exclude before treating a bradyarrhythmia?

A

High vagal tone
Hyperkalaemia - addisons, urinary obstruction, anuric RF
Hypothyroidism
Drug side effects

Small Animal Cardiology (9 decks)

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