Cardiorespiratory and Critical Care - Cardiac Emergencies Flashcards by Jasmine Lelliott

What side of the heart does myxomatous mitral valve disease originate from?

left side

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What breeds are affected by myxomatous mitral valve disease?

small breeds

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What sided heart failure is dilated cardiomyopathy from?

left side

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What size breeds are affected by dilated cardiomyopathy?

large breeds

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What side of the heart is pericardial effusion affected?

Right side

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What type of heart failure can young dogs get?

congenital heart disease

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What type of congestive heart failure can cats get?

biventricular failure

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What type of biventricular heart failure do cats get?

hypertrophic cardiomyopathy

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What veins are affected by right sided congestive heart failure?

systemic veins

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What direction does ressure go in from the cranial and caudal vena cava?

upwards

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What can pericardial effusion be secondary to?

a tumour

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What type of failure is left and right sided?

backward

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What is forward failure?

reduced cardiac output

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What will you see with right or left sided forward failure?

weak peripheral pulses and tachycardia

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What conditions can be caused by left sided heart failure to the lungs?

pulmonary oedeam
tachypnoea/dyspnoea
coughing

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Is a cough caused by heart failure of heart disease?

heart disease

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How can the body be affected by right sided heart failure?

distended peripheral veins
ascites, pleural effusion

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What causes weak peripheral pulses?

decreased stroke volume

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How is left sided heart failure presented?

heart murmur
tachypnoea/dyspnoea
tachycardia
pale, prolonged capillary refill time
arrhythmias?
weak peripheral pulses, pulse deficits

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What common symptom is seen in forward heart failure?

pale mucous membranes

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What can be seen with systolic dysfunction?

weak peripheral pulses

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What clinical approach can be used with left sided congestive heart failure?

taking history
physical exam
stabilisation before diagnostic testing

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Stabilising left sided congestive heart failure?

minimise stress
sedation?
oxygen supplementation
furosemide IV
pimobedan PO/IV

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What sided heart failure can you give furosemide to?

left and right

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What does furosemide do for heart failure?

reduces pressure in the heart and the drive to push fluid out of circulation and into body cavitites

What does pimodendan do?

reduces stroke volume

What would you do an echocardiography for? left sided heart failure

diagnosis and severity

What would you do a thoracic radiograph for? left sided heart failure

diagnose pulmoary oedema

What would you do an electrocardiography (ECG) for? left sided heart failure

check for arrhythmias

What are you doing a blood pressure test for? left sided heart failure

checking for hypotension

What would a blood test check for? left sided heart failure

electrolytes, renal parameters

Why might you do an ECG? left sided heart failure

If you have discovered pulse deficits

How can you monitor a patient with left sided heart failure?

- respiratory rate and effort - blood pressure - heart rate and pulse quality - ECG if arrhythmias are detected - thoracic radiographs

What respiratory rate are we aiming for?

less than 40 breaths per minute

Why might you perform thoracic radiographs? left sided heart failure

if the patient isn't improving and to check for pulmonary oedema

What should you do once the patient has stabilised?

- optimise therapy - start feeding as soon as possible revisit blood tests

What happens if a patient has cardiac cachexia?

lose body weight and muscle condition

What causes right sided congestive heart failure?

- pulmonic stenosis - tricuspid dysplasia - pericardia effusion

How would you diagnose right sided heart failure?

- history and physical exam - echocardiography - thoracic radiograph - electrocardiology - CT

What would you do an echocradiograph for? right sided heart failure

diagnosis and neoplasia

Why would you do a thoracic radiograph for right sided heart failure?

check heart size

What would you do an electrocardiograpm for? right sided heart failure

check for arrhythmias

Why would you do a CT? right sided heart failure

check for neoplasia

What is a pleural effusion?

increased fluid in the pericardium

What is a tamponade?

when the right atrium collapses due to increased external pressure

What happens when cardiac output is decreased?

filling of the right side of the heart is impaired

What causes decreased cardiac output?

idiopathics and neoplastics

How would you treat a pericardial effusion?

pericardiaocentesis and intravenous fluid administration

How would you prepare for a pericardiocentesis?

- clip and prep the area - large catheter or chest drain - measure the volume that is removed - send sample for cytology

Does pericardial effusion clot?

no, if it clots it is likely from the heart

What do diuretics do?

decrease venous return

What treatment would you do post-pericardiocentesis?

- improve cardiovascular parameters - (heart rate, pulse strength, demenour) - hospitalise 12-24 hours - pericardial effusion can reoccur - monitor

What is the msot common cause of feline cardiac emergencies?

hypertrophic cardiomyopathy

How can heart failure be precipitated in felines?

stress or anaesthesia

How would a cat in cardiac emergency present?

- murmur, gallop sounds - tachypnoea, dyspnoea, open-mouth breathing - tachy or bradycardia - weak peripheral pulses - hypothermia

When might bradycardia be more severe in cats?

in heart failure

What might occur if there is sudden onset hindlimb paresis/paralysis in cats?

arterial thromboembolism

What are the five P's? (cat)

- pallor/cyanosis of pads and nail beds - pain - paresis/paralysis - pulselessness - poikilothermy

What is poikilothermy?

cold leg

What is arterial thromboembolism?

clots in the left atrium

How would you stabilise a cat during a cardiac emergency?

- avoid stress - oxygen supplementation - furosemide IV/IM - drain pleural effusion - gentle warming - analgesia

What is the diagnostic approach for feline cardiac emergencies?

- history and physical exam - stabilisation - echocardiogram - thoracic radiographs - electrcocradiogram - blood pressure measurement - blood test

What nursing care would you provide to a feline with a thromboembolism

- warm soft bedding - physiotherapy

What kind of arrhthmias are there? 2

bradyarrhythmias and tachyarrhythmias

How would a patient with an arrhythmia present?

- syncope/collapse - weakness/exercise intolerance - signs of congestive heart failure - abnormal slow rhythm - weak peripheral pulses - heart rate too fast, too slow, or irregular