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SAM_1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is an increase in heart contractility called

A

positive inotropy

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2
Q

What an increase in heart rate called

A

positive chronotropic

tachycardia

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3
Q

with long term low blood pressure (low renal blood flow), the RAAS system is activated. What are the components of this

A

RAAS is renin-angiotensin-aldosterone-system.

Kidney

angiotensin constricts blood vessels

  • veins increase return
  • artery increase pressure

aldosterone retains Na+ (water)

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4
Q

Which 3 characteristics of the pulse are considered in a physical examination?

A

rate

rhythm

quality

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5
Q

What age of animal is more likely to have aortic stenosis

A

Young-congenital

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6
Q

What do inotropes do

A

increase heart contractility

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7
Q

What are the 2 most common acquired cardiac conditions in dogs

A

myxomatous atrioventricular valvular degeneration (endocardiosis)

dilated cardiomyopathy

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8
Q

Which cardiac condition is most common in large breed dogs

A

dilated cardiomyopathy is more common in LB dogs

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9
Q

what cardiac condition is more common in small breed dogs

A

Myxomatous atrioventricular valvular degeneration is most common in SB dogs

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10
Q

What breed of dog is especially know for Myxomatous atrioventricular valvular degeneration

A

King Charles Spaniels

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11
Q

what is the common presenting complaint of dogs with left
congestive heart failure (CHF).

A

a chronic productive cough

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12
Q

Differential diagnoses for dyspnea (8)

A

abdominal masses,

diaphragmatic rupture,
fractured ribs,

pleural effusions and

pneumothorax,

pneumonia/

pulmonary neoplasia,
tracheal foreign bodies

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13
Q

Differential diagnosis for syncope (7)

A

heart failure,

arrhythmias,

stenoses,

low BP,

drugs,
hypoglycemia

vasovagal

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14
Q

differential diagnosis for ascites (3)

A

right CHF

liver disease,

hypoalbuminemia

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15
Q

hyperthyroidism causes what cardiac condition in cats

A

myocardial hypertrophy in cats

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16
Q

Most common heart problem in cats

A

hypertrophic cardiomyopathy

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17
Q

differential diagnosis for bradycardia

A

sleep

excessive parasympathetic tone

diseases of the conduction system of the heart

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18
Q

the differential diagnosis for tachycardia

A

heart failure,

fear

excitement,
exercise,

pain

elevated temperature

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19
Q

The three things assessed during cardiac auscultation are rate, rhythm, and quality

What is rhythm as it relates to the heart

A

time intervals between pulses

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20
Q

three things assessed with cardiac auscultation are rate, rhythm, and quality.

what are the 4 abnormal pulse qualities

A

hyperkinetic

hypokinetic

water hammer

alternating

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21
Q

2 non-cardiac differentials for hyperkinetic pulse

A

exercise

anemia

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22
Q

4 differentials for hypokinetic pulse

A

dilated cardiomyopathy

shock

aortic stenosis

pericardial effusion

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23
Q

conditions with decreased (hypokinetic) left ventricle

A

dilated cardiomyopathy

shock

aortic stenosis

pericardial perfusion

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24
Q

What are the 4 abnormal characteristics that can be described with mucous membranes

A

pale

cyanotic

brick red

delayed CRT

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25
Q

what are the 3 causes for pale mucous membranes

A

fear

left heart failure

shock

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26
Q

what are the 2 causes for cyanotic mucous membranes

A

Right-to-left shunt

severe left heart failure

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27
Q

what is the cause of brick red mucous membranes

A

erythrocytosis

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28
Q

what the causes of delayed CRT

A

decreased left ventricular output

peripheral vasoconstriction (fright, shock)

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29
Q

what causes the apical beat

A

counter-clockwise twist of the heart against the chest wall

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30
Q

what causes the apical beat to shift cranially

A
  • tumors,
  • abscesses
  • hernias

in the caudal thorax

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31
Q

what causes the apical beat to shift caudally

A

enlarged thymus;

enlarged presternal lymph nodes
abscesses

cardiac enlargement.

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32
Q

How does cardiac enlargement shift the apical beat

A

The apical beat is shifted cranially

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33
Q

What causes are there for increased strength of apical beat

A

increased strength of apical beat

young and thin animals

anemia,

pyrexia,
excitement,

fear,

pain,

hyperthyroidism,

shunts

cardiac enlargement

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34
Q

What causes are there for decreased strength of apical beat

A

weak apical beat

shock,

heart failure,

obesity,

emphysema or

tumors of the lungs,

diaphragmatic hernias
pleural effusions

pericardial effusion

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35
Q

What causes the normal heart sounds

A

Heart sounds come about as a result of valve movements and/or turbulence in blood flow

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36
Q

What causes sound 1 during auscultation

A

Closure of the AV valves causes sound 1

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37
Q

Where is sound one best heard during auscultation

A

at the apical beat- closure of AV valves

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38
Q

Where is sound two best heard

A

is best heard over the aortic and pulmonary valves.

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39
Q

it is abnormal to hear S3 in the dog and cat. What causes it in small animals

A

S3 occurs as a result of rapid passive filling of a massively enlarged left ventricular (turbulence)

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40
Q

Sound four is not normally heard in small animals. what disease causes the atria closure to be heard

A

S4 is from hypertrophic cardiomyopathy (decreased ventricular compliance

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41
Q

What causes a gallop heart sound

A

The presence of an extra heart sound results in a gallop rhythm

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42
Q

What causes a split S1 in cardiac auscultation

A

A split S1 occurs as a result of the left and right AV valves closing at different times

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43
Q

What are the causes for the AV valves to close at different times

A

Causes for split S1

  • disturbances in AV conduction,
  • increased pulmonary arterial pressure,
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44
Q

what heart sounds are heard with a protodiastolic gallop

A

a protodiastolic gallop

S1, S2, S3

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45
Q

What heart sounds are heard with a presystolic gallop

A

presystolic gallop

S4, S1, S2

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46
Q

What causes a split S2

A

A split S2 occurs as a result of the aortic and pulmonary valves closing at different times

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47
Q

systemic or pulmonary hypertension cause what heart sound

A

Split S2- aortic and pulmonary valves closing at different times

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48
Q

What causes a systolic click

A

chordae tendinae snap tight as the degenerative mitral valve protrudes into the left atrium

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49
Q

What is an early sign of mitral valve degeneration

A

systolic click

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50
Q

Which valve is the mitral

A

Left AV is the mitral valve

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51
Q

what pathology is associated with a split S2 from the heart

A

Pulmonary hypertension

Severe heartworm disease

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52
Q

What should be assessed during cardiac auscultation

A

Cardiac auscultation-

frequency,

intensity,

rhythm,

murmurs

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53
Q

what causes murmurs

A

audible vibrations produced by turbulent blood flow

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54
Q

does an increase or decrease in blood viscosity cause a murmur

A

decreased viscosity (thin blood) causes more turbulence- murmur

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55
Q

diastolic murmurs are very rare, what causes them

A

aortic or pulmonic valve insufficiency

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56
Q

What causes a washing machine, machine or to-and-fro murmur

A

merging of systolic and diastolic continuous murmurs

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57
Q

which valve is the mitral

A

Left AV

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58
Q

which valve is the tricuspid

A

Right AV

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59
Q

which valve is the aortic

A

Left ventricular is the aortic valve

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60
Q

which valve is the pulmonary valve

A

Right ventricular

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61
Q

where do murmurs from mitral endocardiosis radiate

A

tricuspid

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62
Q

what can diminish the intensity of a murmur

A

obesity,

emphysema

tumors of the
lungs,

diaphragmatic hernias and

pleural or pericardial effusions

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63
Q

Which grade of murmur is heard immediately over a small area

A

grade 3/6

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64
Q

what grade of murmur is hear over most of the chest, but does not have a thrill

A

grade 4/6

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65
Q

what grade of murmur has a thrill

A

grade 5/6

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66
Q

what grade of murmur is heard after a few seconds of auscultation

A

grade 2/6

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67
Q

what grade of murmur is heard after prolonged auscultation

A

grade 1/6

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68
Q

Subjective evaluation of how the murmur sounds to
the listener - harsh, rough, musical, whooping, blowing refers to what

A

quality of murmur

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69
Q

crescendo, decrescendo plateau describe what about murmurs

A

the configuration

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70
Q

which murmurs have the configuration of crescendo or decrescendo

A

aortic stenosis

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71
Q

what configuration of murmurs have plateau

A

AV insufficiency (regurgitation)

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72
Q

with what cardiac disease will the liver edges be rounded

A

Right CHF

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73
Q

what are cardiac causes of distented jugular veins

A

Right CHR

Pericardial effusion

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74
Q

The main use of the ECG (EKG)

A

characterize arrhythmias and conduction disturbances

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75
Q

define heart failure

A

cardiac output is insufficient to meet the needs of the tissues

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76
Q

What is the most common heart disease in dogs

A

mitral valve disease

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77
Q

T/F

cardiac hypertrophy is caused by pressure or volume overload

A

True, as a result of heart disease

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78
Q

chronic increased diastolic pressure causes what

A

eccentric hypertrophy

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79
Q

Another name for endocardiosis

A

mitral valve disease

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80
Q

another name for mitral valve disease

A

endocardiosis

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81
Q

what is afterload

A

the resistance the ventricle encounters as it tries to eject blood

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82
Q

what is the resistance the ventricle encounters as it tries to eject blood called

A

afterload

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83
Q

the ability to dilate in diastole is called

A

lysotrophy

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84
Q

decreased filling in diastole increases what

A

increased preload

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85
Q

cardiogenic shock is the result of what

A

severely decreased blood flow

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86
Q

In L side heart failure, the decreased forward stroke volume results in what clinical signs

A

hypotension

pale
mucous membranes,

prolonged CRT

tachycardia,

weak pulses
lethargy,

depression,

weakness,

exercise intolerance

prerenal azotemia

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87
Q

In L side heart failure, the high end-diastolic pressure results in

A

pulmonary edema,

coughing,

dyspnea

orthopnea,

tachypnea,

exercise intolerance

cyanosis

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88
Q

In R side heart failure the decreased forward stroke volume results in

A

hypotension,

lethargy,

depression,

weakness,

exercise
intolerance

prerenal azotemia

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89
Q

In R side heart failure the high end-diastolic pressure results in

A

distension of veins
ascites,

hepato- and splenomegaly,

pleural effusion
rarely, peripheral edema

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90
Q

What phase is heart disease but no clinical signs

A

phase 1

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91
Q

Phase I heart disease

A

heart disease, but no clinical signs

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92
Q

in what phase of L heart failure is Cough, fatigue and dyspnea with normal or strenuous exercise seen

A

Phase 2

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93
Q

what clinical signs are seen with phase 2 left heart failure

A

Cough, fatigue and dyspnea with normal or strenuous exercise

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94
Q

Cough, fatigue, dyspnea and orthopnea at night and with any activity is seen in what phase of L heart failure

A

Phase 3

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95
Q

what clinical signs are seen in phase 3 left heart failure

A

Cough, fatigue, dyspnea and orthopnea at night and with any activity

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96
Q

In what phase of left heart failure is cyanosis seen

A

phase 4

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97
Q

what is characteristic of phase 4 left heart failure

A

cyanosis

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98
Q

What is ECG mainly used for

A

used mainly to determine heart rate and conduction disturbances

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99
Q

what is the pacemaker of the heart

A

Sinoatrial (SA) node

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100
Q

What causes the SA node to depolarise and hopefully begin a heart beat

A

cells spontaneously depolarize

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101
Q

Which part of the heart’s conduction system is fast, and which is slow

A

Fast- atria and His- purkingy

Slow- Atrioventricular (AV) node

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102
Q

In what recumbency is a dog placed for ECG

A

R lateral

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103
Q

How long and fast is a rhythm strip

A

15-20 beats at 50mm/second

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104
Q

What are the ECG artifacts

A

electrical interference

panting

trembling

respiration

purring

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105
Q

Normally what does 1 cm, vertically represent

A

1 mV

106
Q

how is 1 mV usually measured on ECG

A

1 vertical cm

107
Q

What is a normal MEA for a dog?

A cat?

A

Dog MEA is +40 to+100

Car is 0 to +100

108
Q

What does a greater than normal MEA represent

A

R ventricular enlargement

right bundle block

109
Q

what does a smaller than normal MEA represent

A

Left ventricular enlargement

left bundle block

110
Q

What is the normal P wave width

A

.04 seconds

111
Q

what does it mean if the p wave is wider than .04 seconds

A

L atrial enlargement

112
Q

What is the normal P wave amplitude in dog and cat

A

Normal P wave amplitude:

Dog is .4 mV

Cat is .2 mV

113
Q

What does it mean when the p wave amplitude is greater than normal

A

R atrial enlargement

114
Q

What values indicate bilateral atrial enlargement

A

P wider than .04 seconds in dog or cat

and

P amplitude higher than .4 in dog and .2 in cat

115
Q

In what lead is the S wave assessed

A

S wave is assessed in lead 1,2,3 and aVF

116
Q

What is normal voltage in L. ventricle (R wave)

Small dog, large dog

Cat

A

L. ventricle voltage:

small dog: 2.5 mV

Large dog: 3 mV

Cat: .9 mV

117
Q

What is the normal duration of R wave in:

Small dog, large dog

Cat

A

R wave duration:

Small dog: .05 seconds

Large dog: .06 seconds

Cat: .04 seconds

118
Q

What are the ECG indications of L ventricular enlargement in the dog, not cat

A

Increased voltage

Increased duration

MEA less than normal (40)

119
Q

What are the ECG indications of L. ventricle enlargement in a cat

A

Increased voltage of R wave- ONLY

greater than .09 mV

120
Q

what is the only way to assess the L. ventricle of a cat for enlargement

A

Increased voltage of the R wave in Lead 2

Greater than .9 mV

121
Q

To assess right ventricular enlargement what waveform is assessed in the dog.

A

The S wave in Lead 1,2,3 and aVF (not a cat)

122
Q

To assess the canine right ventricle for enlargement, the S wave is assessed in Lead 1,2,3 and aVF

What are the normal values

what is the MEA if enlarged

A

normal S values

Lead 1: .05 mV

Lead 2, 3 and aVF: .35 mV

MEA greater than 100

123
Q

What ECG evidence is used to determine R. ventricular enlargement in the canine

A

Larger than normal S wave in lead 1,2,3, aVF (not cat)

and

Increased MEA

124
Q

What is the only way to assess R ventricular enlargement in a cat using ECG

A

increased MEA

greater than 160

125
Q

Why can’t biventricular enlargement be assessed like with the atria

A

L ventricular mass over-rides the Right’s smaller mass

126
Q

What does a wide QRS wave with Wide S wave indicate

A

Right bundle branch block

127
Q

What ECG pattern will be seen with Right bundle branch block

A

Wide QRS and S wave

128
Q

What are the 3 differentials for wide-bizarre QRS complexes on ECG

A

Right bundle branch block

Right ventricular enlargement

Ventricular premature depolarization (VPD)

129
Q

What are the causes of Right bundle branch block

A

infections, neoplasia, infarction, fibrosis or cardiac trauma

130
Q

What are the hemodynamic consequences of Right bundle branch block

A

None

131
Q

What are the causes of Left bundle branch block

A

infections, neoplasia, infarction, fibrosis or cardiac trauma

132
Q

What are the hemodynamic consequences of Left bundle branch block

A

None

133
Q

How can left bundle branch block be distinguished from Left ventricular enlargement on ECG

A

With LBBB there is no increased voltage in R wave

134
Q

A longer than normal QRS with no increased voltage suggests what cardiac abnormality

A

Left Bundle branch block

135
Q

Intermittent wide QRS waveforms are suggestive of what cardiac abnormality

A

L. bundle branch block

136
Q

Enlarged ventricles and bundle branch blocks cause prolonged QRS waves. How can bundle blocks and enlarged ventricles be differentiated

A

With enlarged ventricles, the MEA is changed (Left is less)(Right is more) and the waveform is continuously wide with increased voltage

With Bundle branch blocks, the wide QRS is intermittent and normal voltage

137
Q

A differential for left bundle block is ventricular premature conduction. how can VPCs be ruled out?

A

with VPC there is a disconnect between P-R

With bundle branch blocks there is a constant P-R relationship

138
Q

What defines low voltage QRS on ECG

A

low voltage QRS are less than 1 mV in small dog and less than 1.4 mV in large dog

139
Q

What are the 5 causes of low voltage QRS complexes

A

obesity,

effusion- pleural or pericardial

hypothyroidism,

pneumothorax

diffuse myocardial disease

140
Q

What are the normal depression and elevation from baseline for ST segment

A

Elevation .15 mV

Depression .2mV

141
Q

What does an abnormally elevated or depressed ST segment indicate

A

myocardial ischemia

142
Q

what is the ECG sign of myocardial ischemia

A

abnormally depressed or elevated ST segment

143
Q

what are the normal values for QT interval in dog and cat

A

QT interval

Dog: .15 to .25 seconds

Cat .12 to .18 seconds

144
Q

What electrolyte imbalance cause changes in QT interval

A

Calcium and potassium levels effect QT interval

145
Q

In addition to electrolytes, what are the other causes of abnormal QT intervals

A

digoxin,
antiarrhythmic drugs,

antibiotics,

drugs used to modify behavior

All can change the QT interval

146
Q

What causes a tall spiked T wave

A

Hyperkalemia

147
Q

What is the normal height of the T wave in dog?

In cat?

A

Dog: 1/4 R wave is normal T wave. Can be negative, positive or biphasic

Cat: max .3mV- may not see

148
Q

What is abnormality in the rate, rhythm or flow of depolarization (origin) through the heart called

A

arrhythmia

149
Q

Which lead is used to determine if arrhythmia is present

A

Lead 2

150
Q
A
151
Q

There is a normal P wave for every normal QRS complex but the R-R intervals vary. what arrhythmia

A

sinus arrhythmia

152
Q

What arrhythmia is associated with respiration

A

Sinus arrhythmia

Wandering atrial pacemaker

153
Q

what is a sinus arrhythmia most commonly associated with

A

respiration

154
Q

heart rate increases with inspiration and decreases with expiration due to changes in vagal tone. What arrhythmia

A

Sinus arrhythmia

155
Q

What arrhythmia is associated with normal changes in vagal tone

A

sinus arrhythmia

156
Q

What is the treatment for sinus arrhythmia

A

None required

157
Q
A

Sinus arrhythmia

158
Q

P waves are not initiated at the SA node but rather elsewhere in the atria

A

Wandering atrial pacemaker

159
Q
A

Wandering atrial pacemaker

160
Q

P waves are variable and cannot be used to determine atrial size

A

wandering atrial pacemaker- no treatment necessary

161
Q

what arrhythmia is associated with exaggerated parasympathetic tone

A

sinus bradycardia

162
Q

what arrhythmia occurs when ventricular rate is too slow

A

sinus bradycardia

163
Q

What is the heart rate associated with sinus bradycardia in small dog, large dog and cats

A

small dog: less than 70 bpm

large dog: less than 60 bpm

cat: less than 100 bpm

164
Q

hereditary stenosis of the Bundle of His in Pugs causes what arrhythmia

A

sinus bradycardia

165
Q

surgical procedures on the eye can cause what arrhythmia

A

sinus bradycardia

166
Q

digoxin, zylazine, anesthetics, anti-arrhythmics can cause what arrhthmia

A

sinus bradycardia

167
Q

Hyperkalemia can cause what arrhythmia

A

sinus bradycardia

168
Q

hypothyroidism can cause what arrhythmia

A

sinus bradycardia

169
Q

what are the drug treatments for sinus bradycardia

A

terbutaline, isopropamide, pro-banthine

170
Q

For which arrhythmia is an atropine test used to diagnose

A

sinus bradycardia

171
Q

what does a positive atropine test mean for sinus bradycardia

A

If the HR increases the sinus bradycardia was caused by increase parasympathetic tone. Treat with drugs

172
Q

prolonged failure of the SA node to initiate one or more impulses is what arrhythmia

A

sinus arrest

173
Q

what does angiotension do

A

constricts blood vessles

174
Q

what does aldosterone do

A

retains Na+ (water)

175
Q

A pulse with a water hammer quality is commonly associated with what heart abnormality

A

aortic regurgitation

176
Q

What drugs are associated with sinus bradycardia

A

Digoxin

Beta blockers

Xylazine

177
Q

What electrolyte abnormality can lead to sinus bradycardia

A

hyperkalemia

178
Q

What causes sinus bradycardia in pugs

A

fibrosis of connection between AV node and bundle of His

179
Q

What endocrine disorder can cause sinus bradycardia

A

Hypothyroid

180
Q

What cardiac change would be noted if an abscess was pressing on the vegas nerve.

A

sinus bradycardia

181
Q

to determine if sinus bradycardia was of a vagal origin, what test is performed

A

Atropine stimulation test- if heart rate increases the bradycardia is due to vagal problem

182
Q

What is the drug used for long-term treatment of sinus bradycardia

A

terbutaline- alpha agonist

183
Q

what is an escape beat

A

It’s a beat generated by the ventricle after prolonged SA arrest

184
Q

If an escape beat originates close to the av node, what is it called

A

junctional or nodal escape beat- QRS looks normal, but slower rate

185
Q

what is a junctional or nodal escape beat

A

a beat generated by the ventricular, but near the AV node, so QRS looks normal, but rate is slow.

186
Q

What are the parasympatholytic treatments for bradycardia

A

isoproterenol

probanthine

187
Q

What is the cause of this waveform morphology

A

Hyperkalemia

188
Q

What are the treatments of hyperkalemia

A

Sodium Bicarbomate,

glucose/insulin

Calcium gluconate

189
Q

hereditary stenosis of the Bundle of His is known in what breed of dog

A

Pug

190
Q

prolonged conduction through the AV node {P-R interval >
0.13 s (dog) or 0.09 s (cat) with normal rythm

A

First degree AV block

191
Q

What does a first-degree AV block look like

A

Normal rhythm, but PR interval is prolonged

192
Q

What is a mobitz type 1 referring to

A

Second degree AV block where the PR interval gets progressively longer

193
Q

what is a mobitz type 2 referring to

A

a second-degree av block that randomly drops the the QRS

194
Q

What happened

A

Sinus arrest

195
Q

What is a normal SA rate?

a normal AV rate

A ventricular rate?

A

SA=100 bpm

AV= 40-60

Ventricular= 20-40

196
Q

What is third degree AV block

A

there is no conduction from the atria to the ventricles and each beat independently

197
Q

What is the P-wave rhythm with 3rd degree AV block

A

The P-wave rhythm is normal- 100 bpm

198
Q

With a third degree AV block, The ventricle contracts independently from the SA node in the atria. What is the ventricular rhythm for 3rd degree AV block?

A

Independent from SA. If from AV node, 40-60 BPM, if from the Ventricle 20-40 bpm

199
Q

Where does the junctional rhythm originate from?

A

AV node

200
Q

Where does the idioventricular rhythm originate from

A

The ventricle

201
Q

How can an owner know if loss of consciousness is from seizure or syncope?

A

After an episode:

Seizure- will show signs of postictal abnormalities

Syncope- will be normal

202
Q

What is the treatment drug treatment for sinus bradycardia

A

terbutaline

203
Q

With increased K+, the T wave becomes tall and spiked. With higher levels of K+, what are the waveform characteristics?

A

T wave disappears, QRS is prolonged and wide. Sinusoidal shape

204
Q

What accounts for the sinusoidal appearance of the waveform?

A

Hyperkalemia

205
Q

One treatment for hyperkalemia is Ca gluconate. How do you know when you’ve given enough

A

Patient will become nauseous- salivation, licking lips

206
Q

How does insulin/glucose treat hyperkalemia?

A

It drives K+ into the cells

207
Q

What will the K+ level be in a dog with hypoadrenocorticism?

A

K+ will be high

208
Q

What drug can be used to stabilize the AV block patient before a pacemaker is implanted

A

Isoproterenol infusions may be used to stabilize

209
Q

Does a 1st degree AV block need to be treated?

A

No, monitor only

210
Q

Wenkebach phenomenon

A

heart block (2nd degree AV) in which a pulse from the atrium periodically does not reach the ventricle and which is characterized by progressive prolongation of the P-R interval until a pulse is skipped

211
Q

What AV block is this

A

2nd degree AV block with Wenkebach phenomenon- Mobitz type 1

212
Q

The alpha 2 agonist, Xylazine is associated with what cardiac arrhythmia

A

2nd degree AV block. An occasional P is not followed by a QRS

213
Q

What arrhythmia is characterised by dropped beats occur without any progressive changes in the P-R interval

A

2nd degree AV block, specifically Mobitz type 2

214
Q

This waveform is characteristic for which treatment of AV block

A

pacemaker of 3rd degree AV block

215
Q

What arrhythmia is characterised by a sinus bradycardia, intermittent periods of sinus arrest or AV block, long periods of asystole, and escape beats, with periods of compensatory tachicardia

A

sick sinus syndrome

216
Q

What arrhythmia shows abnormally high heart rate with normal P and QRS-T complexes

A

Sinus tachycardia

217
Q

Which lead is on the arm + or - ?

A

Negative is on arm

218
Q

What arrhythmia is associated with beats that occur earlier than expected (premature) and arise from outside the SA node

A

Supraventricular premature depolerizations (SPD)

219
Q

During auscultation of the heart, you hear a lub, with no pulse. What arrhythmia is suspected

A

SPD- supraventricular depolarizations

220
Q

What arrhythmia is characterised by more than 3 SPDs in a row?

A

supraventricular ventricular tachycardia

221
Q

If there is an extra conduction pathway between the SA node and the ventricle, what arrhythmia might be seen.

A

SPD -supraventricular premature depolerization

SVT -supraventricular tachycardia

222
Q

What is the most common emergency treatment for SVT

A

esmolol- Beta blocker

223
Q

What are the two drugs for maintenance treatments of SVT

A

sotalol- Beta-blocker for atrial origin

diltiazem- Ca++ channel blocker for extra conduction pathway

224
Q

For which arrhythmia would pathway ablation be used for treatment

A

Supraventricular tachycardia

225
Q

what is it called when ventricular beats that arise from an ectopic focus in the ventricles

A

Ventricular premature depolarization/contraction

VPD/VPC

226
Q

If a VPD results in a QRS, below baseline, where is the ectopic center?

A

Left ventricle

227
Q

If a VPC is above the baseline, where is the ectopic center?

A

Right ventricle

228
Q

What arrhythmia is associated with GVD Gastric dilation-volvulus

A

VPD ventricular premature depolarization

229
Q

What arrhythmia is associated with pancreatitis and sepsis

A

VPD

230
Q

What are the only 2 premature arrhythmias

A

SPD-supraventricular premature depolarization

VPD- ventricular premature depolerization

231
Q

The only premature arrhythmias are VPD and SPD. how are the different on ECG

A

VPD has wide and bizarre QRS and can be positive or negative

SPD has normal QRS

232
Q

What is the name of the arrhythmia in which every second beat is a VPD?

A

bigeminy

233
Q

What are the signs of VPD

A

dropped heart sound

Irregular pulse

dropped pulses

sudden death

rarely syncope

234
Q

When is specific treatment of VPDs indicated?

A

Signs of heart failure

concurrent disease associated with sudden death

R-on-T

VPDs longer than 30 min

235
Q

What is the specific treatment for VPD with multiform or R-on-T?

A

Lidocaine

236
Q

T/F Splenic surgery is know to cause VPD

A

True

237
Q

With what underlying disorders should VPD’s be treated?

A

Boxer cardiomyopathy

DCM in Doberman

aortic stenosis

HCM in cats

High rate- increased risk of R-on-T

238
Q

Lidocaine is the first choice for treating emergency VPD. What is plan B

A

Beta blocker- if contractility is good

procainamide- higher risk

239
Q

The first choice for treatment of canine VPD is lidocaine, what is the first choice in cats

A

Beta blockers: (help heart relax)

propranolol, atenolol

then lidocaine as plan B

240
Q

When should cats with VPD be treated

A

concurrent HCM

241
Q

By definition what is ventricular tachycardia

A

Runs of 3 or more VPDs at high rate of greater than 160 bpm

242
Q

What heart rate can be associated with ventricular tachycardia clinical signs

A

300 bpm for 6 seconds

243
Q

What are runs of VPDs that are too slow to be called V-tach called

A

accelerated idioventricular rhythm

244
Q

What is the usual cause of Accelerated idioventricular rhythm/ idioventricular tachycardia

A

electrolyte imbalance-

HBC and rapid decrease in Ca++

245
Q

When is it necessary to treat Accelerated idioventricular rhythm/ idioventricular tachycardia?

A

No treatment necessary, but should work to improve electrolyte imbalance

246
Q

What is the treatment for ventricular fibrillation

A

Electrical cardioversion

Epinephrine

CPR

247
Q

What can R-on-T trigger

A

V-fib

248
Q

What arrhythmia is associated with irregular R-R interval, but normal QRS

A

atrial fibrillation

249
Q

Dobermans are predisposed to dilated cardiomyopathy, as a consequence what arrhythmia can be seen

A

atrial fibrillation

250
Q

What arrhythmia sounds like boots in a dryer

A

Atrial fibrillation

251
Q

The treatment choices for A-fib depend on the ventricular response and species. What is the treatment of choice for high ventricular rate with good output in canine? What is plan B

A

Diltiazem - Ca++ channel blocker

Plan B is Beta blockers: esmolol, sotalol

252
Q

What is the treatment of choice for a fib associated with decreased ventricular function?

A

Combination of diltiazem and digoxin

253
Q

What effect will a Ca++ channel blocker like diltiazem have on the heart?

A

negative inotropic

254
Q

What effect will beta blockers have on heart

A

negative inotropic

255
Q

For which arrhythmias is DC cardioversion indicated

A

Cardioversion _shockable arrhythmias

A-fib pg. 25

Ventricular tachycardia pg. 21

V-fib pg. 25

Asystole associated with above

256
Q

What drugs must be used life long after DC cardioversion of A-fib?

A

sotalol

amiodarone

257
Q

What arrhythmia is associated with a sawtooth pattern

A

Atrial flutter

258
Q

What is the drug of choice for feline A-fib

A

Propanolol

259
Q

what drug is counterindicated for feline A-fib?

A

Digoxin is counterindicated

260
Q

What arrhythmia is associated with this saw-tooth pattern

A

Atrial flutter

261
Q

Atrial flutter is associated with a saw tooth pattern. What is a common sequela

A

A-fib

SAM_1 (6 decks)

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