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Equine Med Final (Old Material) > Cardiology (key concepts only hopefully) > Flashcards

Cardiology (key concepts only hopefully) Flashcards

1
Q

Valsalva maneuver

A
  • Put pressure on the vein and milk the one below
  • The part that you milked should not refill
  • If it fills back, there is an atrial problem
  • If it refills in a pulsating way, issue is likely with the tricuspid valve
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2
Q

Where does ventral edema typically show up?

A
  • NOT IN THE LIMBS
  • Under the chin
  • Bottom of the abdomen
  • Pectoral muscles
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3
Q

Hyperkinetic pulses

A
  • Aortic insufficiency
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4
Q

Weak pulses

A
  • Indicate poor cardiac contractility, ventricular filling or ejection
  • Also seen in systemic conditions like hypovolemia, endotoxemia
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5
Q

How to determine if a systolic murmur?

A
  • If you feel the pulse when you hear the murmur, then it is systolic
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6
Q

HR for an adult horse

A

-28-44 BPM

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7
Q

HR for a newborn foal

A

80-120 BPM

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8
Q

S1

A
  • Closing of AV valves
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9
Q

S2

A
  • Closure of aortic and pulmonic valves
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10
Q

S3

A
  • Rapid ventricular filling
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11
Q

S4

A

Atrial contraction (best heard on the left side)

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12
Q

B-lub dup

A

4-1-2

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13
Q

Lub drub

A

S1-S2-S3

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14
Q

Make sure you can determine ECG leads

A
  • do it
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15
Q

Physiologic murmurs

A
  • Common (fit horses, neonates, systemic disease)

- Systolic

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16
Q

What is more common: regurgitation or stenosis?

A
  • Regurgitation
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17
Q

If you hear a diastolic murmur which valve is most likely affected?

A
  • Aortic valve
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18
Q

Aortic valve murmurs

A
  • Heard during diastole
  • Aging horse murmurs
  • Often have bounding pulses
  • Don’t have exercise intolerance
  • Monitor with an echo once a month
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19
Q

Mitral valve regurgitation

A
  • Systolic on the left side
  • Exercise intolerance
  • Eventually goes to heart failure
20
Q

Tricuspid regurgitation

A
  • On the right side
  • Intensity does = severity on this one
  • Can get a jugular pulse with this
21
Q

Ventricular septal defect

A
  • Younger horses

- SYSTOLIC murmur (blood goes from left to right

22
Q

Patent ductus arteriosus

A
  • Continuous murmur, loudest on the left side in a newborn foal
  • Normal for 3-5 days
23
Q

What is the best test for evaluating a murmur?

A
  • Echocardiography
24
Q

What is the best test for arrhythmia evaluation?

A
  • ECG
25
Q

Heart disease clinical signs

A
  • Ventral edema
  • Jugular pulse
  • Peripheral vein distention
  • Poor condition (Chronic)
  • Small
  • Growing slowly
26
Q

Physiologic arrhythmias

A
  • Common due to high vagal tone
  • Not always present
  • Disappear with exercise and excitement
27
Q

2nd degree AV block

A
  • Dropped beat
  • Only hear the atrial contraction (would be S4)
  • If you trot the horse, it will go away
  • Usually due to high vagal tone
28
Q

Pathologic arrhythmia causes

A
  • Common
  • Heart
  • Metabolic disturbances (electrolyte disorders, colic, diarrhea, endotoxemia)
29
Q

Atrial fibrillation ECG appearance

A
  • f waves may be seen
  • some QRS
  • Missing p waves
30
Q

Atrial fibrillation

A
  • Most common arrhythmia
  • Irregularly irregular
  • Sounds like shoes in the drier
  • Disorganized electrical signals
31
Q

Clinical signs of atrial fibrillation

A
  • Poor performance
  • Unnoticed (if the horse isn’t performing)
  • May be diagnosed while doing a physical exam on a dental
32
Q

Definitive diagnosis of AF

A
  • ECG

- Echocardiography (Atrial abnormalities)

33
Q

Medical cardioconversion treatments for atrial fibrillation

A
  • Quinidine gluconate (IV) - can be given if you KNOW FOR SURE that it has been there for less than 2 weeks
  • Quinidine sulphate (NGT)
34
Q

Quinidine sulphate cost and risks

A
  • Very corrosive; will burn down the esophagus
  • Can cause local irritation, colic, lethargy, anorexia, arrhythmias
  • Cheap
  • Can cause paraphemosis
  • Edema in the nasal passage
  • Give flunixin for pain
  • Continuous monitoring
  • Try five or 6 doses giving once every hour and reducing dose every time
35
Q

Other attempt for treating atrial fibrillation

A
  • Amiodarone (much more expensive)

- May not be more effective

36
Q

Atrial fibrillation prognosis

A
  • If <3 months, prognosis is ~90-95% convert with 25% recurrence
  • If >4 months, recurrence is higher
  • If you have to do more than once, prognosis will worsen
37
Q

Signs from increased right ventricular filling and systemic venous pressure

A
  • Peripheral edema
  • Vein distention
  • Jugular pulse

(think of this as backwards failure)

38
Q

Signs from heart dilatation and valve failure

A
  • Decreased cardiac output
  • Tachycardia
  • Heart failure

(think of this as more forward failure)

39
Q

Thrombophlebitis local irritation

A
  • Extravascular injection
  • Phenylbutazone is really bad
  • Catheter
40
Q

Thrombophlebitis associated with systemic disease

A
  • Endotoxemia

- DIC

41
Q

Clinical signs of thrombophlebitis

A
  • Hard and ropy vein
  • Pain and heat
  • Proximal edema
  • Increased collateral damage
  • Fever with lethargy and anorexia
  • Local abscess or necrosis
42
Q

What to do if your jugular catheter blows on one side?

A
  • If it’s healthy, put it on the other side

- If it’s sick, she will save the other side for euthanasia

43
Q

Catheter sites*** (THIS IS PROBABLY THE QUESTION)

A
  • if they have two jugulars you can put one on the other side
  • Can use the lateral thoracic (point cranially)
  • Can put it on the cephalic vein
44
Q

Where can you NOT put a catheter in an adult horse? (AGAIN, likely associated with the question she would ask)

A
  • Saphenous on the medial side of the back leg
45
Q

Diagnosis of thrombophlebitis

A
  • Can ultrasound

- Always culture your catheter

46
Q

Treatment of thrombophlebitis

A
  • Flunixin
  • Cold and hot packs to ease pain
  • Topical NSAID
  • Antibiotics

Equine Med Final (Old Material) (11 decks)

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