Cardio Consensus

Question 1

HCM - systolic or diastolic dysfunction?

Answer 1

Diastolic dysfunction

Question 2

DCM- systolic or diastolic dysfunction?

Answer 2

LV systolic dysfunction w eccentric hypertrophy (dilation)

Question 3

S3 heart sound

Answer 3

Ventricular filling

Question 4

S1 heart sound

Answer 4

Closure of AV (mitral and tricuspid) valves

Question 5

S2 heart sound

Answer 5

closure of semilunar (aortic and pulmonary) valves

Question 6

If you hear a 3rd heart sound (gallop) on a cat, what would you think of it

Answer 6

3-19% cats with subclinal HCM. not usually present in healthy cats

Question 7

Heart sound with HCM

Answer 7

S4 gallop

Question 8

What cats are at highest risk of HCM

Answer 8

Male, older, loud systolic murmur
Most are nonpedigree, but Maine Coon, Ragdoll, British shorthair, Persian, bengal, sphinx, Norwegian forest cat, Birman breeds predisposed

Question 9

What gene mution has been associated with HCM?

Answer 9

Myosin binding protein C gene (MyBPC3)

Maine coon - 35-42% prevalence (MyBPC3-A31P)

Question 10

What gene mutation has been described in Ragdolls with HCM

Answer 10

MyBPC3-R820W mutation

Question 11

What can be seen in rads of a cat with HCM

Answer 11

Severe cardiomegasly
Left auricular bulge over DV/VD

Question 12

T/F: valentine heart shape is specific to HCM

Answer 12

FALSE

Question 13

What adverse effects can we see w spironolactone in cats

Answer 13

Ulcerative dermatitis

Question 14

CO = ?

Answer 14

SV (preload, after load, contractility) x HR

Question 15

What receptors and where have a permissive effect of SNS activation under RAAS in CHF?

Answer 15

Beta receptors in macula densa

increase SNS –> renin release –> increase AGII, catecholamine release

Question 16

Where does furosemide work and how

Answer 16

Loop diuretic – thick ascending loop of henle
Impairs activity of NaK2Cl cotransporter
No effect on carbonic anhydrase, does not antagonize aldosterone

Question 17

What happens when you give thiazide after giving furosemide?

Answer 17

Distal tubule will hypertrophy and become hyperactive in the setting of loop diuretic –> sequential nephron blockade leads to progressive increases in Na depletion (affects DCT)

Question 18

Where does thiazide work

Answer 18

Distal tubules
MOA: interferes transport of Na ions across renal tubular epithelium

Question 19

MOA digoxin

Answer 19

Inhibits Na/K ATPase
Increases Ca entry into cell = weak + inotrope
Decrease SA firing and AV conduction (negative chronotrope)
Prolongs refractory period

Question 20

MOA pimobendan

Answer 20

Calcium sensitizer and inhibition of phosphodiesterase III (PDE-III)
Positive inotrope
Make myofilaments more sensitive to Ca so we get increase contractility without increasing the Ca

Question 21

Tx of AFIB

Answer 21

Digoxin
Diltiezam - #1
Beta blockers - worsens CHF