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Cardio #2 Flashcards

1
Q

What can endocardiosis of the mitral valve lead to?

A. Volume overload of LV

B. Pressure overload of LV

A

A

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2
Q

What is congestive heart failure?

A

Clinical term referring to cardiac decompensation - the metabolic demands of the body are no longer met due to abnormal cardiac function.

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3
Q

How do you determine CHF?

A

Have to look away from the heart - heart lesions are not enough to establish failure as compensation may be maintaining function

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4
Q

What is happening here? What can we call this if we cannot determine the cause?

A

Eccentric ventricular hypertrophy (bilateral); can call it dilated cardiomyopathy

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5
Q

What are common causes of left-sided heart failure?

A

Valve disease, myocardial hypertrophy/cardiomyopathy, systemic hypertension, congenital anomalies (i.e. VSD), myocarditis, neoplasm

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6
Q

What is endocardiosis and what are some characteristics?

A

NOT inflammatory!

Degenerative condition of the valve;

Small tiny bumps on free edge of valve leaflets, idiopathic, common in middle aged to older dogs, more common in AV valves (esp. bicuspid) than semilunar, can lead to eccentric hypertrophy, jet lesions may occur

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7
Q

What is this?

A

Endocardiosis

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8
Q

What is the most common cause of CHF in dogs?

A

endocardiosis

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9
Q

What is happening here?

A

Valvular endocarditis - pure exudate (fibrin, neutrophils, granulation tissue)

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10
Q

What is valvular endocarditis prone to?

A

thrombosis

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11
Q

What are the effects of left heart failure on the lungs and why?

A

Congestion and edema (blood backs up into pulmonary circulation, raises hydrostatic pressure)

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12
Q

What are the effects of left sided heart failure on the kidneys?

A

Decreased perfusion –> decreased GFR –> stimulation of renin-angiotensin –> increased aldosterone –> retained salt and water, increased BP due to vasoconstriction

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13
Q

What is the main symptom of left sided heart failure?

A

pulmonary edema and coughing

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14
Q

What are the effects of left sided heart failure on the brain?

A

Hypoxia, mental confusion

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15
Q

What is happening here?

A

Pulmonary edema with widened interlobular septa

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16
Q

What organ is this, which one is normal, and what is happening in the abnormal one?

A

Lung; top is normal; bottom has pulmonary edema - protein-rich fluid filling alveoli and congested alveolar septa

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17
Q

What are some common causes of right sided heart failure?

A

Increased pulmonary resistance, valvular disease, hydro/hemopericardium, pericarditis, heartworm disease, myocardial hypertrophy/cardiomyopathy, congenital defects, myocarditis, infiltrative neoplasm

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18
Q

What is cor pulmonale?

A

Pulmonary hypertension leading to right heart failure

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19
Q

What will happen systemically if there is right heart failure?

A

Systemic venous congestion

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20
Q

What are symptoms of systemic venous congestion?

A

Peripheral edema, ascites, hydrothorax, hydropericardium, hepatic and splenic congestion

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21
Q

Provide a morphological diagnosis. What side of the heart is involved?

A

Skin: subcutaneous edema, severe, focal, chronic

Right sided heart failure

22
Q

Provide a morphological diagnosis. What side of the heart is involved?

A

Abdomen: hydroperitoneum (ascites), diffuse, chronic, severe

Right sided heart failure

23
Q

What is happening here? What side of the heart is involved? Provide a morphological diagnosis.

A

Passive congestion of the liver

Liver: congestion, diffuse, acute, severe

Right sided heart failure

24
Q

Of the following lesions, which would you expect to see with chronic left sided heart failure vs. right sided?

A. Ascites (hydroperitoneum)

B. Pulmonary edema

C. Cerebral hypoxia

D. SQ edema

E. Hepatic congestion

F. Decreased perfusion of the kidneys

A

A = Right

B = Left

C = Left

D = Right

E = Right

F = Left

25
Q

What are the two possible types of myocardial hypertrophy?

A

eccentric and concentric

26
Q

What is cardiomyopathy?

A

Hypertrophy with no identifiable cause

27
Q

Provide a morphological diagnosis.

A

Heart: eccentric hypertrophy of right ventricle, diffuse, chronic, severe

28
Q

What causes eccentric hypertrophy?

A

Volume overload (preload)

29
Q

What does the heart to that leads to eccentric hypertrophy?

A

Attempts to get a more forceful contraction

30
Q

What is this?

A

eccentric hypertrophy

31
Q

What does the myocardium in eccentric hypertrophy look like?

A

Thin wall, larger chamber than normal

32
Q

What causes concentric hypertrophy?

A

Chronic pressure overload (afterload)

33
Q

What does the myocardium look like in concentric hypertrophy?

A

Chamber wall is thickened

34
Q

Provide a morphological diagnosis.

A

Heart: concentric hypertrophy of right ventricle, diffuse, severe, chronic

35
Q

Is concentric hypertrophy a systolic or diastolic dysfunction?

A

Mainly diastolic because there is nowhere for the blood to go

36
Q

What are some common cardiac congenital defects?

A

VSD, pulmonic stenosis, sub- or aortic stenosis

37
Q

What does pumonic stenosis lead to?

A

RV concentric hypertrophy

38
Q

What does sub- or aortic stenosis lead to?

A

LV concentric hypertrophy

39
Q

What are the components of tetralogy of Fallot?

A
  1. High VSD
  2. Over-riding aorta
  3. Pulmonic valve stenosis
    1. RV concentric hypertrophy
40
Q

What are two malformations that cause increased cardiac pressure?

A

Aortic stenosis, pulmonic stenosis

41
Q

What are cardiac malformations that cause shunting of blood?

A

Ventricular septal defect, patent ductus arterosus, atrial septal defect

42
Q

What direction is blood shunted in cardiac malformations?

A

Left to right

43
Q

What types of cardiac malformations are seen in the great vessels?

A

Fusion of aorta and pulmonary artery, translocations of aorta or pulmonary artery, persistent right aortic arch, Tetralogy of Fallot (common in cattle)

44
Q

What can persistent right aortic arch lead to?

A

megaesophagus

45
Q

What is seen here? Provide a morphological diagnosis.

A

Heart: (sub)aortic stenosis with left ventricular concentric hypertrophy, chronic, diffuse, severe

46
Q

What is denoted by the blue arrow?

A

patent ductus arteriosus

47
Q

Topper is an 8 year old male mixed breed dog with no significant prior medical problems. When out into the yard this morning. Owners saw the dog running. When they went to bring Topper in he was down, non responsive, and was not breathing.

What is your morphological diagnosis? How did he die?

A

Hemopericardium; died from cardiac tamponade - rupture caused bleeding into pericardial sac

48
Q

This lesion will likely cause:

A. Acute heart failure

B. Chronic heart failure

A

A

49
Q

This lesion will likely cause:

A. Diastolic dysfunction

B. Systolic dysfunction

A

A

50
Q

Which side of the heart will be most affected?

A

Right side

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