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Equine (fourth year) > Cardiology > Flashcards

Cardiology Flashcards

1
Q

why are cardiac issues much less common in horses than dogs?

A

they have a huge cardiac reserve at rest

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2
Q

how do horses with cardiac disease generally present?

A

incidental at pre-purchase exam
poor performance
systemic illness

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3
Q

what valve does the most prominent beat occur on?

A

mitral

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4
Q

what is the apex beat of the horses heart over?

A

mitral valve

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5
Q

what valve is listened to on the right of the horse?

A

tricuspid

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6
Q

what is systole and diastole?

A

systole - contraction
diastole - relaxation

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7
Q

what causes S1?

A

ventricles contract and the AV valves close (mitral/tricuspid)

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8
Q

what causes S2?

A

ventricules relax and semilunar valves shut (aortic/pulmonic)

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9
Q

what causes S4?

A

atrial contraction

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10
Q

when is S4 heard?

A

just before S1

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11
Q

what causes S3?

A

end of rapid ventricular filling (difficult to hear)

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12
Q

when is S3 heard?

A

just after S2

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13
Q

why does mitral valve regurgitation cause a loud S3?

A

there is more blood in the atria due to the regurgitation so ventricular filling is even faster due to the pressure

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14
Q

how does the length of systole compare to diastole in the normal heart beat?

A

systole is much shorter

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15
Q

how does the length of systole compare to diastole with a fast heart beat?

A

systole and diastole become much similar in length

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16
Q

what is a murmur?

A

turbulent flow of blood

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17
Q

turbulence of blood is influence by Reynolds number, what is Reynolds number influenced by?

A

vessel diameter
blood velocity
blood density

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18
Q

how is a grade 1 murmur described?

A

barely audible

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19
Q

how is a grade 2 murmur described?

A

definite murmur quieter than S1 and S2

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20
Q

how is a grade 3 murmur described?

A

obvious loud murmur as loud and S1 and S2

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21
Q

how is a grade 4 murmur described?

A

very loud murmur louder than S1 and S2

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22
Q

how is a grade 5 murmur described?

A

very loud with a palpable thrill

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23
Q

how is a grade 6 murmur described?

A

audible with stethoscope just off chest wall

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24
Q

how can the timing of a murmur be described?

A

systolic
diastolic
continuous
(mid, early, late, pan, holo)

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25
Q

what ways can a murmur be described?

A

grade
timing
point of maximal intensity
radiation
shape of murmur
quality of murmur

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26
Q

how would a murmur from aortic valve regurgitation be described?

A

holodiastolic
between aorta and left ventricle
decrescendo

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27
Q

how would a murmur from mitral valve regurgitation be described?

A

holosystolic
between left atrium and ventricle
plateau

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28
Q

what are the two categories of murmurs?

A

physiological (functional)
pathological

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29
Q

when is an aortic flow murmur heard?

A

early-mid systole

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30
Q

where is an aortic flow murmur localised to?

A

heart base

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31
Q

what are the two main physiological murmurs?

A

flow and filling

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32
Q

when is a filling murmur heard?

A

early diastole

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33
Q

what animals is a filling murmur heard in?

A

fit young horses

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34
Q

what sound does a filling murmur make?

A

squeak/whoop

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35
Q

how would the murmur heard with mitral/tricuspid regurgitation be described?

A

holo/pansystolic
plateau or crescendo
PMI heart apex

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36
Q

why is tricuspid regurgitation less severe than mitral?

A

right side of heart (tricuspid) is under less pressure

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37
Q

how would a ventricular septal defect murmur be described?

A

loudest on right
pansystolic
radiates cranial/ventral

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38
Q

how would an aortic insufficiency murmur be described?

A

decrescendo (buzzing)
holodiastolic
PMI left heart base

39
Q

what age horses is an aortic insufficiency murmur heart in?

A

teenage (moaning sound)

40
Q

why is a patent ductus arteriosus murmur a constant murmur?

A

because there is always a pressure gradient

41
Q

what age horses is patent ductus arteriosus murmur common in?

A

young horses (first 5 days of life)

42
Q

what is oedema?

A

abnormal and excessive accumulation of fluid in the interstium

43
Q

how does generalised oedema often present in horses?

A

accumulated in the lowermost part of the body (dependant oedema)

44
Q

how is excess fluid drained from the interstitial space?

A

via the lymphatic system

45
Q

what causes fluid to leave the vessels at the arterial end of capillaries?

A

hydrostatic pressure

46
Q

what causes fluid to enter the vessel at the venous end of the capillary?

A

oncotic pressure

47
Q

what are the four mechanisms that can cause oedema?

A

increased capillary hydrostatic pressure
decreased capillary oncotic pressure
lymphatic obstruction
increased capillary permeability

48
Q

what are some possible causes of decreased oncotic pressure?

A

protein losing enteropathy
protein losing nephropathy
haemorrhage
chronic hepatopathy

49
Q

what are some possible causes of lymphatic obstruction?

A

confinement (standing still for too long)
tumours
post-partum
lymphangitis

50
Q

what are the three main causes of increased vascular permeability?

A

vasculitis
SIRS (endotoxaemia)
local inflammation

51
Q

what happens to white blood cells in cases of SIRS?

A

they stick to the blood vessel walls

52
Q

what happens when neutrophils stick to blood vessel walls in cases of SIRS?

A

causes damage to the wall

53
Q

why do gums become congested in SIRS cases?

A

body loses ability to send blood to places that need them the most - generalise vasodilation

54
Q

does losing a gram of globulin or albumin from blood have more effect on the oncotic pressure?

A

albumin (smaller molecule so more molecules are lost per gram)

55
Q

what are some possible infectious causes of vasculitis?

A

infectious equine viral arteritis
herpes virus 1
infectious anaemia
Hendra
African horse sickness

56
Q

what are the possible routes of transmission of infectious equine viral arteritis?

A

respiratory or venereal

57
Q

what are the possible clinical signs of infectious equine viral arteritis?

A

pyrexia, dull, oedema, stiff gait, abortion, respiratory disease

58
Q

what can cause an immune mediated vasculitis?

A

allergy/hypersensitivity

59
Q

what is a severe generalised immune mediated vasculitis called?

A

purpura haemorrhagica

60
Q

what types of hypersensitivity can cause a vasculitis?

A

1 - IgE
3 - immune complex

61
Q

what parasite is associated with verminous vasculitis?

A

Stongylus vulgaris

62
Q

what is the most common place for an aneurysm/rupture in stallions?

A

aortic root

63
Q

what is thrombophlebitis?

A

blood clot that sticks to an inflamed vessel wall

64
Q

where is thrombosis common in horses?

A

aortic-iliac
jugular from catheterisation

65
Q

what is lymphangitis?

A

inflammation/infection of lymph vessels

66
Q

how does lywmphantiis usually present?

A

swollen leg, painful on palpation but can bear weight

67
Q

how is lymphangitis treated?

A

NSAIDs
possible antimicrobials
topical cleaning and cold treatment
encourage walking and movement

68
Q

what is the function ion the AV node?

A

slow the wave of depolarisation down to prevent the atria and ventricles contracting at the same time

69
Q

what is the point of the refractory period in cardiomyocytes?

A

to ensure it cannot contract again straight away

70
Q

what factors can alter the resting and threshold potential of cells?

A

autonomic nervous system
potassium, sodium and calcium concentrations inside compared to outside of the cell
drugs

71
Q

what effect will the parasympathetic system have on the heart?

A

triggers acetylcholine release which opens potassium channels on the pacemaker cells which lowers the resting potential meaning it will take longer to reach the threshold potential

72
Q

where are the electrodes placed for equine ECG?

A

left arm (positive) - heart apex
right arm (negative) - mid right jugular furrow

73
Q

what does the P wave show on ECG?

A

atrial depolarisation

74
Q

what does the P-R interval of an ECG show?

A

AV node slowing the depolarisation

75
Q

what does the QRS complex show on an ECG?

A

ventricular depolarisation (atria depolarises here)

76
Q

what does the T wave of an ECG show?

A

ventricular repolarisation

77
Q

what are the common arrhythmias in horses?

A

first/second degree AV block
sinus arrhythmias and tachycardia/bradycardia
atrial premature complexes
atrial fibrillation
ventricular premature complexes
ventricular tachycardia

78
Q

what happens during second degree AV block?

A

regular SA node depolarisation and conduction pathway but AV node stops the spread of depolarisation every 3-4 beats

79
Q

what heart sound can be heard when there is a dropped beat due to second degree AV block?

A

S4

80
Q

is second degree AV block pathological or physiological in horses?

A

physiological - often clears with sympathetic tone (exercise….) - resting horses

80
Q

is second degree AV block pathological or physiological in horses?

A

physiological - often clears with sympathetic tone (exercise….) - resting horses

81
Q

what happens on an ECG during a first degree AV block?

A

prolonged P-R complex

82
Q

what happens on an ECG with sinus arrhythmias?

A

P-R interval waxes and wanes

83
Q

what does atrial fibrillation sound like?

A

trainers in a washing machine - all the beats but completely random

84
Q

what are the most common presenting complaints of horses with atrial fibrillation?

A

poor performance
fading during a race
epistaxis
(incidental in low work horses)

85
Q

what is the treatment for atrial fibrillation based on?

A

increasing the refractory period to prevent the wave being able to continue around the atria

86
Q

what is the prognosis for horses with secondary atrial fibrillation?

A

poor - don’t bother treating

87
Q

what are the main options for cardioversion to treat atrial fibrillation?

A

pharmacologic conversion (quinidine sulphate)
transvenous electrical cardioversion

88
Q

what are the side effects for quinidine sulphate used to treat atrial fibrillation due to?

A

blockage of sodium channels (GI tract, nervous, muscles…)

89
Q

why are currents for transverse electrical cardioversion placed on the skin?

A

would create too much heat as too higher current would be required so it would cook the animal

90
Q

what is done to see if a horse with atrial fibrillation is safe to ride?

A

do an exercising ECG to look for rhythms and determine risk of collapse - looking to see if it alters the ventricular beats

91
Q

what causes an atrial premature complex?

A

ectopic pacemaker in the atria (oddly shaped P wave)

92
Q

how is it determined if the ectopic pacemaker is atrial or ventricular?

A

atrial - P wave effected
ventricular - QRS wave effected

Equine (fourth year) (11 decks)

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