Cardiology clinical Flashcards
1
Q
mutation du doberman pour DCM
A
PDK4 & titin, autosomal dominant
2
Q
mutation Maine coon pour HCM
A
Mybp3 - A31p, autosomal dominant
3
Q
mutation ragdoll pour HCM
A
Mybp3 - r820w, higher risk of cardiac death
4
Q
mutation boxer ARVC
A
striatin, autosomal dominant
5
Q
reason for presentation of boxer for ARVC
A
syncope (1/3 - 2/3)
6
Q
myxomatous mitral valve disease
A
A - predisposition genetique
B - malade mais pas de signe clinique
B1 - preclinical - mitral regurgitation
B2 - La/ao 1.6, LVDd > 1.7, VHS > 10.5, ssag 3/6,
C - ICC , MST 1 an une fois CC
D - refractory, dog : 8 mg/kg/d
7
Q
indication for pimobendane
A
b2, retarde l’apparition d’ICC 15 mois
8
Q
negative pronostic factors
A
- rupture of cordae
- PH
- syncopal
- arrhytmias
9
Q
MOA of pimobendane
A
- inhibitor of PDEI 3 (via AMPc pathway) : Ca2+ sensitization in cardiomyocyte, inodiolatator
- vasodilatation
10
Q
MOA furosemide
A
inhibitor de la pump Na, K, 2 Cl , thick portion of ascending loop of henle
11
Q
Torsemide
A
x10 furosemide
12
Q
only predictor of risk of cardiac failure in MVD
A
thrill
13
Q
only acquired disease in dog with sexual predisposition
A
male + , MVD
14
Q
2 breeds with AF before DCM
A
irish wolhound, newfoundland
15
Q
1 breed with TV before DCM
A
doberman , Great Dane
16
Q
Other breeds predisposed for DCM
A
- Standard Schnauzer RBM20
- Welsh springer spaniel : phospholamban
17
Q
Taurine deficiency DCM
A
Cocker, Golden Retriever
18
Q
Non-genetic causes of DCM
A
- Nutritional : deficiency in taurine - lamb & riz , carnitine (Boxer), rich in legumes, grain free, low protein
- Endocrinopathy : Hypothyroidism, Addison
- Tachyarrythmia
- Toxins : doxorubicin, monensin
- Myocarditis, myocardial ischemia
- Other dz resulting in systemic dysfunction
19
Q
Form juvenile of DCM
A
- Portuguese water dog, Toy manchester terrier
20
Q
Negative pronostic factors in DCM
A
- Worst in DP & Great Dane
- FA
- age at onset
- CHF : ascite, pleural, pulmonary edema
21
Q
Tx of DCM
A
- Pimobendane (DP 9 mo delay shows ICC)
- ACEi for DP delays ICC
22
Q
Px of DCM in CHF
A
19 we (3 mo)
if no CHF 2 yo for DP
23
Q
Pathogeny of ARVC
A
remplacement of tissue by fatty - fibrofatty tissue or RV
24
Q
Presentation of ARVC
A
- striatin, autosomal dominant, worst presentation in homozygous
- male
- 5-7 yo
- boxer
- 30% no echocardiography changes
- 30% sudden death
25
Suspicion ARVC
- more than 100 VPCm likelihood increases with complexity, couplet, v-tach
- increased cTNI significantly in boxer but overlap
26
Tx of ARVC
- sotalol or mexiletine
- Criterias :
> 300 VPC with complexity
>1000 VPC
runs of v-tach
27
genetic predisposition
28
myocarditis infectious
- lyme - boxer
- bartonellose
- trypanosoma (ventricular arrythmias, or AV block)
- neo, toxo
- parvo (3-8 weeks old)
- distemper
- leishmania
29
endocarditis risk factor
- immunosuppression
- hx surgery in the last 3 mo
- skin infection
- indwelling infection
- heart disease : SAS +- PDA
- male
- medium to large dogs
30
agents infectieux - relation to presentation of endocarditis
- gram + , chronic to sub acute (staph, strept)
- gram - , acute onset (e. coli, barto, p. aeuginosa)
31
complications of endocarditis
30-40% thromboembolism, in order of importance - lungs , kidnys, distal aorta
- Immune complex
32
type of murmur, and how common in endocarditis
- 75%
- to and fro, majorly diastolic
33
is blood culture often positive
negative 70%
34
Negative pronostic factors for endocarditis
- gram (-)
- hypoalbuminemia
- bartonella
- septic emboli
- azotemia
- ALP elevation
- Aortic
- thrombocytopenia
35
Positive pronostic factor
- gram (+) - skin infection
36
HCMo breeds
persian, chartreux
37
RCM types
- myocardial : relatively normal LV dimentiations with LA or biatrial enlargement, most common
- Endomyocardial : proeminent endocardial scar bridging IVs + LV free wall + atrial enlargement
38
negative pronostic for DCM in cats
hypothermia
39
fx with death associated with HCM
- spontaneous echocontrast, regional wall hypokinetic, restrictive diatolic patern, diminution fonction systolique, LVH > 9 mm, RV enlargement , left atrial enlargement
40
HCM secondary causes
hyperT4, acromegaly, HT, TMT, myocarditits, infiltrative disease, decreased pre load
41
DCM prognosis in cat
49 days
42
ACVIM stage in cats
- A : predisposed breeds to disease
- B : preclinical (no clinical signs)
*B1 : low risk : normal atrial size, no risk factors for b2
*B2 : high risk CHF et ATE
- la enlargement, spontaneous echocontrast, thrombus
- hypokinetic ventricular wall
- decreased FR % (function systolic)
- hypertrophy extreme of LV
- gallop , arrhythmias
- C : ICC or ATE
- D : refractory, 6 mg-kg-d
43
Prevalence of HCM
15% sur la population ( 30% older cats)
44
Negative px factor in D
cardiac cachexia
45
atrial myopathy
labrador retrievers, english springer spaniel
=> atrial standstill
46
most common congenital heart disease
Dogs : PDA, SSA, SSP
Cats : VSD, TVD, PDA
47
Breeds - sex predisposition for PDA
- bichon, chihuahua, maltese, pomeranian, yorkie
- sheltie, corgie
- poodle, cocker, keeshond, english springer spaniel, lab, Collie
- GSD
Females ++
48
closing of pda
7-10 days after birth (due to sudden decrease in pulmonary vascular resistance => no flow => no O2, leading to increased PG and vasoconstriction)
49
type of murmur pda + pulse
continous heart murmur, left heart base + mitral murmur
hyperkinetic
50
describe cardiac changes in PDA (left to right)
volume overload, excentric LEFT
51
thoracic radiogrpahis of PDA
- enlarged left heart, enlarged left atrium
- pulmonary overcirculation (dilatation art pulmonartery)
- aortic buldge
(3 bulges : artery pulmonary, aortic + atrium)
52
causes of reversing pda
- juvenile : form of your pda (no tapering at the pulmonary ostium so the pressure in aorta directly transmitted to pulmonary artery so develop HTP and then will reverse)
- later in life : pulmonary hypertension
53
reversing pda clinical signs
* no heart murmur (mild)
* differential cyanosis
* after a high altitude sejour
* erythrocytosis
54
tx of reversing pda
* non surgical
* sildenafil
* hydroxyurea +- phlebotomy
* risk of hyperviscosity syndrome with PCV > 68%, cause of death
55
MST without tx of PDA
less than 2 y
if reversed less 1 y
56
aortic stenosis
- sous aortic : GR, newfoundland (genetic mutation PICALM) ; main location
- aortic : bullterrier
- attention souffle physiologique du boxer (smaller aortic annulus)
57
tx aortic stenosis
atenolol
bad response of balloon dilatation (because of aortoseptal change)
58
aortic stenosis clinical exam
- basal gauche , ejection murmur
- hypokinetic pulses
- the disease develops until 12 mo (HR murmur appears 8 we)
59
ASD breeds
- Boxers (Doberman samoyed), proven genetic in Keeshond
- Chartreux , Persan
60
ASD auscultation
soft systolic murmur, left heart base, splited S2 ; no heart murmur
61
ASD changes
- flow during ventricular diastole, right dilatation atrium + eccentric hypertrophy of RV and pulmonary overcirculation
62
VSD breeds
- english bulldogs et english springer spaniel, WHWT
63
VSD types
- perimembranous: systolic, sang va dans l'artere pulmonaire => changes excentric gauche (car va directement dans l'artere pulmonaire donc augmente la circulation pulmonaire)
- muscular, rare (diastolic right HR)
64
Mitral stenosis breed
Bull Terrer
GSD
Golden
65
heart murmur of mitral stenosis
SSAG (rarely diastole)
66
pulmonic stenosis types and breeds
valvular : beagles, basset, giant schnauzers, westie
supravalvular : english bulldogs, boxer, associated with abnormal coronary arteries => no dilation
67
moderate and severe : give pressure of pulmonic stenosis and tx
moderate 50-80, severe 80
candidates for sx if severe of clinical signs (syncopal, exercice intolerance)
68
tetralogy fallot breed
keeshond, english bulldog
69
anomaly tetralogy fallot
- pulmonic valve stenosis (RV outflow obstruction due to infundibular obstruction)
- rv hypertrophy
- dextroposition of aorta
- large perimembranous VSD
CHF uncommon but they will reverse so same complications
70
volume of pericardial cavity
0.3 - 1 mL
71
2 types of presentation of pericardial effusion
rapid : cardiac tamponnade = low cardiac output (impairment of ventricular filling)
chronic : right heart failure
72
main 2 causes of pericardial effusion
1. neoplasm 2. idiopathic
73
most common secondary mets of HSK right atrium
2. spleen,1. lungs
74
breeds most commonly represented with La rupture
poodle, daschund, cocker, sheltie
75
HSK cardiac vs splenic metastasis %
25-30 % - HSK splenic cardiac metastasis
and vice versa
76
chemodectoma : localisation et breeds
- heart base
- brachycephalic : boxer, bulldog, boston terrier
77
EKG of pericardial disease
electrical alternance in 28%
78
reccurence of idiopathic pericarditis and sequelae
50% => go to sx (subtotal pericardectomy)
sequelae : constrictive pericarditis
79
What is a common underlying etiology for constrictive pericarditis?
Coccidiodes
80
Name the disease
High CVP
Ascites
NORMAL heart on rads
Constrictive pericarditis
(medium to large breeds)
81
PPDH predisposition
weimeraners
long to medium heart
82
negative pronostic factors for ATE
paralysis (no motor function)
Hyperthermia <37*C, moins de 50% de survival
bradycardia
CHF
both limbs
83
Reccurrence of aTE
17-50%
84
second most common cause for ATE in cats
neoplasia (pulmonary)
85
virschow triads
- stasis of blood
- endothelial injury
- hypercoagulable
86
thoracic limb most affected in cats
right
87
what are the characteristics of reperfusion injury of ATE
- hyperkaliemia
- SIRS (radicaux libres de l'oxygen)
- lactates : acidose metabolic
- IRA : myoglobinuria
