Cardiology Flashcards
Name two heartworm treatment risks
anaphylaxis, thrombosis
Normal diastolic BP?
60-110mmhg
Potassium sparing diuretics inhibit _______ in the ______
inhibit aldosterone in the distal tubules
Escape beat hallmark on ECG?
no p-wave (because the SA doesn’t fire and it starts somewhere else)
Dilated Cardiomyopathy - drugs to treat (one injectable, one oral)
Dobutamine (positive inotrope for contractility)
Digoxin (digital glycoside for performance, arrhythmias)
Electrical Conduction 1-5
- SA Node (Atria)
- AV Node
- Bundle of His
- R/L Bundle Branches
- Purkinje Fibers
Beta 2 receptors do what?
RELAX smooth muscle (beta fish = chill) two lungs
Beta 2 - two effects
Bronchodilation
Vasodilation to skeletal
RUN
Three beta BLOCKERS
LOL, you ain’t going anywhere
propranalol, atenalol metroprol
MAP greater than what can lead to retinal detachment
and increased ICP?
> 140mmhg
Vena Cava dumps blood into the ________ atrium, then the ________ valve
Right Atrium
Triscuspid Valve
Normal CVP (cm H20 and mmhg)
0-5cm H20
or 0-3mmhg
Dopamine precursor to what?
Norepinephrine
SVT includes anything above …. includes what 3 things
SUPRA ventricular - anything above the ventricles Above the AV node HR 240-300+, minimal or buried P waves - sinus tach - atrial tach - AV junctional tach
What is an inotrope?
the force or energy of MUSCULAR contraction
Five potential causes of DCM
- toxin
- viral
- metabolic
- nutrition (taurine def.)
- chemo (doxorubicin)
Dirofilaria immitis
Heartworm
What is bigemeny?
Two beats coupled together (such as normal + VPC)
Intermittent SVT is called
Paroxysmal SVT
Pulmonic Stenosis- L or R sided failure?- Sx?
Right sided failure
Stenosis of pulmonary artery- blood can’t get to the lungs so backs up into right side
Balloon Valvuloplasty
Dopamine low dose and effects
1-5mcg/kg/min:
vasodilation - renal mesentereic, cerebral, and coronary arteries
Thiazine Diuretic example, act on ______, inhibit _____ and increase _____ excretion
Hydrochloralazine Acts on PROXIMAL of distal tubuleInhibits Na + reabsorptionIncreases K+ excretion
HCM prone to throwing clots - why?
can’t adequately circulate blood so it hangs around forming clots
Phosphodiesterase inhibitor 2 examples (oral)
Pimobendan and Sildenafil
Tetrology of Fallot- 4 things
- Pulmonic stenosis
- Ventricular septal defect
- Overriding aorta (positioned right over the VSD)
- Right ventricular hypertrophy
Spironalactone drug class and concern with long term use - monitor what?
Potassium sparing diuretic, Can lead to increased K+ over time, monitor kidneys
Milrinone dosing 50mcg/kg, then 0.375-0.75mcg/kg/hr
Milrinone dosing 50mcg/kg, then 0.375-0.75mcg/kg/h
Canine DCM- Main malfunction
Floppy Heart Bag
Decreased Contractility and increased RAAS system
Tricuspid Valve Dysplasia- L or R sided failure?- 2 medications
Right sided failure
- Diuretics (decrease preload)
- ACE inhibitors (enalapril, benazepril)
Blood from lungs dumps into ______ vein, then the _______, then the _______ valve
Pulmonary vein
Left Atrium
Mitral Valve
Dobutamine - 3 side effects
1) nausea/vomiting
2) Tachy arrythmias
3) Hypertension
PDA- Where, when should it close? how to correct?
Excess bloodflow into pulmonary artery from the aorta
- should close 3-4d after birth
- Surgical ligation or coil
Hydralazine dilates what?
arteries only
PDA - right or left sided failure?
- Left sided failure because there’s way too much blood coming back from the lungs (getting extra from our handy PDA hole)
- Volume overloads left side - leading to left sided failure
Total Protein < what indicates need for colloids?
< 3.5g/dl
Negative inotropes do what?
DECREASE muscular contraction (like
Beta 1 receptors act on what?
heart and kidneys
Right bundle branch block looks like what? Do we care?
rabbit ears
- incidental/benign
Lasix CRI dosing
0.1mg/kg/hr
What is esmolol?
Injectable atenolol basically - blocks B1, “test” before starting orals
Chronotropic affects what?
Heart rate
Mitral Valve Dysplasia- L or R sided failure?- Sx?
Left sided failure
Balloon Valvuloplasty
Digoxin/Digitoxin toxicity effects
arrythmias, GI
What is an escape beat?
the normal firing doesnt produce a beat so someone else initiate it - junctional (AV node) or ventricular
Dobutamine 2 most common effects
Increased contractility
Stroke volume
a-fib common in what breed?
irish wolfhounds
Caval syndrome
large amount of heartworms at once - vena CAVA and right atrium
Beta receptors are what?
Fight or flight
Beta 1 - three effects
Heart - increase rate, AV conduction, strength of contraction
Nitroprusside dilates what?
Veins AND arteries (inPRUSSive)
Ventricular escape beat - what does it look like and what’s happening?
SA doesn’t fire - no P wave, wide bizarre QRS
Second degree AV block hallmarks (mobitz I vs II)
Longer, longer, longer drop that’s the one called wenkenbach (mobitz I)
Mobitz II - sometimes P doesn’t get through but no rhyme/reason
easiest to auscultate based on Irregular rhythm - dropped beats
APCs
atria prematurely beat
Beta 1 vs Beta 2
1 heart
2 lungs
Coagulase positive staphylococci and beta hemolyitic streptococci are the common bacteria types in what disease process?
Endocardititis
Positive inotropes do what?
INCREASE muscular contraction (like dobutamine)
Two examples of sympathomimetic amines?
dopamine, dobutamine
Na + Channel Blockers - Class 1- Name 2
- Lidocaine- Procainamide
Feline HCM- Main malfunction- Left sided or right sided?- 2 Drug classes to fix
Thickened left ventricle, left sided failure
Ca+ Channel Blockers (amlodipine) ACE inhibitors (enalapril, benazepril)
Loop diuretics act on _________ by decreasing reabsoption of _____ and _____
Acending loop of henle
- decrease reabsorption of Na & Cl
Dopamine mid range dose and effects
6-10 mcg/kg/min:
systemic arteriol constriction (increase afterload) - beta
Third degree AV block hallmarks
NO communication between SA->AV
If Ps and Q’s don’t agree then you have a third degree (
MAP Calculation
2DS–>3
3
Loop diuretic example
Lasix
Ca+ Channel Blocker - NONDihydropyridine
Diltiazem (dec. contractility, slow AV conduction)
Dopamine high dose and effects
> 10 mcg/kg/min:
alpha cells - vasconstriction
Digital glycosides- example- fixes what arrythmia?
Digoxin- SVT
Left sided heart failure fails to push blood to _________, backs up in _________, and leads to two other clinical signs
Fails to push blood to BODY, backs up into LUNGS.
- Causes azotemia (no diuresis)
- Low protein (low oncotic pressure)
Junctional escape beat - what does it look like and what’s happening
SA doesn’t fire - no P wave, normal QRS
Normal colloid oncotic pressure
8-25mmhg
ACE Inhibitors- mechanism of action, two examples
- Stops conversion of ATI -> Angiotensin II
- Enalapril/Benazapril
Phosphodiesterase inhibitor example and action - 2 injectables
Milrinone and amrinone - arteriole dilators
Right ventricle goes to ______
Pulmonary Artery, then lungs
Four causes for elevated CVP
- volume overload
- pleural/pericardial effusion
- pneumo
- pulmonary hypertension
Amrinone dosing 1-3mg/kg then 10-100mcg/kg/min
Amrinone dosing 1-3mg/kg then 10-100mcg/kg/min
Propranalol drug class - 1 or 2 or both?
Beta Blocker - blocks 1 and 2
Heartworms live where? And cause what sided heart failure?
Right Atrium and Ventricle - cause right sided heart failure
Nitroglycerin dilates what?
veins only
First degree AV Block hallmarks
Prolonged SA->AV but it always makes it
If the R is Far from P then you have a first degree
Right sided heart failure fails to push blood to __________, backs up in _______and leads to congestion of _______.Two clinical signs
Fails to push blood to lungs, backs up in body.
Congestion of spleen and liver
- Weakness
- Syncope
Normal systolic BP?
100-160mmhg
a-fib treatment
ca+ blockers, digoxin, beta blockers
Enalapril/Benazapril are examples of what class? Monitor for what?
ACE Inhibitors
- Can cause hyperkalemia (halts RAAS system)
Normal MAP?
80-120mmhg
Patients on what drug will decrease the dose of esmolol
morphine
Triscuspid valve dysplasia surgical options
Ring annuloplasty (prevents further closing) valve replacement
heartworm treatment
adulticide then microfillaria 4-6 weeks after, sometimes heparin or surgical removal
Left Ventricle pushed blood to….
Aorta - the whole body
Ca+ Channel Blockers - Class 4- Name 2- 3 effects
- Diltiazem- Amlodipine
- arteriol dilator
- decreases contractility
- slows AV conduction
Normal lactate is what?
< 1.0mmol/L
Potential causes of atrial standstill
Hyperkalemia (>7.5meq/L)
- UO
- Addison’s
- DKA
- Bladder rupture
Loop diuretics increase excretion of ________
Everything NaCl, Ca, Mg, Hydrogen, ammonium, bicarb
Ventricular septal defect- What is it?- L or R sided failure?- Main medication for tx?
- Hole between the ventricles
- Right sided failure more common (left is so powerful - path of least resistance)
- ACE inhibitors (enalapril, benazepril)
Dobutamine dosing
5-20mcg/kg/min
Normal colloid oncotic pressure range? Below what needs colloids?
18-25mmhg. Less than 15 needs colloids
Atrial standstill is caused by what?
Hyperkalemia (>7.5meq/L)
Pimobendan dosing 0.1-0.3mg/kg BID, can cause what side effect?
can INHIBIT platelet aggregation
Dobutamine and Dopamine stimulate what receptors?
Beta-adrenergic
SVT treatment - manual and three drugs
- Vagal Maneuver
- Digoxin
- Ca+ blocker (diltiazem, amlodipine)
- Beta Blocker
Potassium sparing diuretic example, onset time,
Spironolactone
Onset 2-3 days
K+ Channel Blockers - Class 3- Name 2
- Amiodorone
- Sotalol
Atenolol and metroprolol block what? good for what cases?
Beta 1 only, Beta 2 at HIGH doses - good for respiratory things because leaves the lungs alone
Where are calcium channels located?
Cardiac and skeletal muscle
Digitalis glycosides - cats are sensitive
Digoxin ONLY, DigitTOXIN is TOXIC to cats
Digoxin toxicity signs
arrythmias, GI
Ca+ Channel Blocker - Dihydropyridine type
Amlodipine - arterial vasodilator
Alpha receptors do what?
CONTRACTS smooth muscle (alpha male)