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Small Animal Medicine > Cardio - Congenital Diseases > Flashcards

Cardio - Congenital Diseases Flashcards

1
Q

How is a grade I murmur described?

A

Soft murmur heard in only 1 valve location, only in very quiet room, may only be intermittent

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2
Q

How is a grade II murmur described?

A

Soft murmur heard consistently, but only in 1 valve area

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3
Q

How is a grade III murmur described?

A

Moderate murmur heard in multiple valve locations on one side of the chest

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4
Q

How is a grade IV murmur described?

A

Loud murmur heard on both sides of the chest

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5
Q

How is a grade V murmur described?

A

Loud murmur heard at all valve locations associated with precordial thrill

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6
Q

How is a grade VI murmur described?

A

Loud murmur heard at all valve locations, even with stethoscope held 1 cm from chest wall

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7
Q

What are the locations for describing murmurs?

A

L apical, L basilar, R apical, parasternal

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8
Q

What are the timing categories for murmurs?

A

Systolic, diastolic, continous, to-and-fro

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9
Q

What are ways to describe the quality of a murmur?

A

Regurgitant (plateau), ejection (crescendo-decrescendo), machinery, decrescendo

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10
Q

What are “innocent” puppy/kitten murmurs?

A

physiologic murmurs without structural heart disease

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11
Q

Why are physiologic murmurs common in puppies and kittens?

A

They have larger SV than adults –> turbulence in Ao/PA

Thinner chest walls

Higher SNS tone

Anemia (lower blood viscosity)

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12
Q

What are characteristics of innocent murmurs?

A

Soft (grade I-III), L-sided, early or mid-systolic, disappear by 4-6 months

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13
Q

What are the most common congenital heart diseases in puppies?

A

PDA, PS, SAS

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14
Q

What is a PDA?

A

patent ductus arteriosus;

Failure of closure of ductus arteriosus (descending Ao –> MPA)

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15
Q

What are the consequences of a PDA?

A

L-R shunt –> LV volume overload –> L-CHF

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16
Q

What is the signalment for PDA?

A

Poodle, Sheltie, Pomeranian, Cocker, Maltese, Yorkie, GSD

Female > male

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17
Q

What kind of murmur is heard with PDA?

A

Continuous “washing machine” murmur at L heart base

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18
Q

What is the prognosis of PDA with and without treatment?

A

With = normal life

Without = POOR

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19
Q

What are the 2 types of treatment for PDA?

A

Interventional catheterization (ACDO)

Surgical ligation (thoracotomy)

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20
Q

What is PS?

A

Pulmonic Stenosis:

Congenital narrowing/thickening of the pulmonic valve

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21
Q

What are the consequences of PS?

A

RV pressure overload –> R-CHF, syncope, arrhythmias

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22
Q

What is the signalment for PS?

A

Smaller breeds (3 Bs: Boxer, Beagle, Bulldog), Chihuahua, Schnauzer

Male = female

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23
Q

What murmur type is heard with PS?

A

Systolic ejection murmur at the L heart base

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24
Q

What is the prognosis of PS?

A

Depends on severity;

Mild = normal lifespan

Severe = guarded with no treatment, good with balloon valvuloplasty

25
Q

What are the treatment options for PS?

A

Mild/moderate = atenolol

Severe = balloon valvuloplasty

26
Q

When should you refer a systolic L-sided murmur to a cardiologist?

A

If it is LOUD (grade IV or higher);

If it is soft, recheck and refer if still present >6 months

27
Q

What is SAS?

A

Subaortic Stenosis

Congenital ridge/narrowing below aortic valve

28
Q

What is unique about SAS?

A

The lesion continues to pregress throughout growth

29
Q

What are the consequences of SAS?

A

LV pressure overload –> LVH –> syncope, arrhythmias, sudden death, L-CHF, endocarditis

30
Q

What is the signalment for SAS?

A

Large breeds (Newife, Boxer, GSD, Gonden, Rottie)

Male = female

31
Q

What type of murmur is heard with SAS?

A

Systolic ejection murmur at L heart base

32
Q

What is the prognosis for SAS?

A

Depends on severity:

Mild = normal lifespan without tx

Severe = ~5 years (bimodal)

33
Q

What is the treatment for SAS?

A

Atenolol if mod/severe;

No good procedure - balloon valvuloplasty NOT effective

This is not a valve that you can just pop open like in PS

34
Q

How long do echoes need to be rechecked in SAS?

A

Continue rechecking as an adult as the disease progresses until dog is fully grown

35
Q

What are other congenital heart diseases in dogs?

A

VSD - R sided murmur

Tricuspid valve dysplasia - Labs, R-sided murmur

Cyanotic heart defects (R to L shunting) - tetralogy of Fallot, reversed VSD/PDA

36
Q

When should you refer a puppy with a murmur?

A

Any continous, diastolic, or R-sided murmur

L-sided murmur if you can hear it on both sides

Any murmur still heard after 6 months

37
Q

What are the most common congenital heart diseases in kittens?

A

VSD, AV valve dysplasia

38
Q

_____ murmurs are more common in cats than dogs, even as adults.

A

physiologic

39
Q

Why are there fewer surgical/interventional options for congenital diseases in cats?

A

They are small

40
Q

_____ heart disease is still a reasonable differential for cats <1 yr

A

acquired

41
Q

What is a VSD?

A

Ventricular Septal Defect:

Abnormal communication between LV and RV

42
Q

What are consequences of VSDs?

A

L-R shunting –> LV volume overload –> L-CHF

43
Q

What type of murmur is seen with VSDs?

A

Systolic plateau or decrescendo murmur @ R side

44
Q

What is the prognosis for a small/restrictive VSD?

A

Normal lifespan with no treatment (LOUD murmur!)

45
Q

What is the prognosis for a large/nonrestrictive murmur?

A

L-CHF (softer murmur)

46
Q

What size VSD is more common?

A

small/restrictive

47
Q

What is the treatment for a small VSD?

A

none

48
Q

What is the treatment for a large VSD?

A

Treat CHF when it occurs;

No corrective procedure in cats (can attempt surgery or device closure in dogs)

49
Q

What is mitral and tricuspid valve dysplasia?

A

Abnormal development and leakage/stenosis of mitral and/or tricuspid valves

50
Q

What are the consequences of MV/TV dysplasia?

A

LV or RV volume overload –> R- or L-CHF

51
Q

What murmur is heard with MV/TV dysplasia?

A

Systolic plateau/regurg murmur @ L or R apex

52
Q

What is the prognosis of MV/TV dysplasia?

A

Depends on degree of dysplasia/regurg/stenosis

53
Q

What is the treatment for valve dysplasia?

A

Treat CHF when it occurs, no corrective procedure available

54
Q

When should you refer a kitten with a murmur?

A

Same rules as dogs, but there are fewer surgical/interventional options for cats

55
Q

What age has innocent murmurs?

A

<4 months

56
Q

What is the intensity of an innocent murmur?

A

I-II, maybe III

57
Q

What is the timing of an innocent murmur?

A

systolic

58
Q

What is the location of an innocent murmur?

A

L side

Small Animal Medicine (100 decks)

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