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Canine/Feline Internal Medicine > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What are the two most common heart conditions in dogs?

A

Chronic valvular heart disease/ mitral valve endocardiosis

Cardiomyopathy

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2
Q

What is the most common heart condition of cats?

A

Hypertrophic cardiomyopathy

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3
Q

Define diastole and systole.

A

Diastole - relaxation (heart refills with blood)

Systole - contraction of heart

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4
Q

What are the values for bradycardia and tachycardia for small and large dogs?

A

Small - 160

Large -

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5
Q

What is the pulse? Give examples of conditions where there’s a hyperkinetic and hypokinetic pulse.

A

Difference between systole and diastole pressure.
Hyperkinetic - anaemia, AV insufficiency, PDA
Hypokinetic - dehydration, myocardium failure

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6
Q

What valves produce S1 and S2 heart sounds?

A

S1 - AV valve closure

S2 - aortic & pulmonary valve closure

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7
Q

Describe the aetiopathogenesis of chronic valvular heart disease.

A

Aetiology is unknown, possibly genetic like CKCS.
Mitral valve collagen degenerates & valve lesions gow causing insufficiecy. Left atrium & veins remodel with extra volume (eccentric hypertrophy).
Can lead to left sided heart failure resulting in pulmonary oedema.
Can get ruptured chordiae tendinae, atrial tears, ascites (if right sided heart fails from working so hard)

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8
Q

10yo Cavalier KCS presents at the clinic coughing morning and night, slight exercise intolerance and mild ascites.

A

Mitral valve endocardiosis (Chronic valvular heart disease)

Get cough from pulmonary oedema (LS heart failure) and LA so enlarged from compensation that presses on bronchus.

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9
Q

How do you diagnose chronic valvular heat disease?

A

Jugular pulse distended >1/3rd up neck
Radiograph for LA enlargement
Ultrasound
Echocardiographs

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10
Q

Treatment for chronic valvular heart disease is well debated. What would you do?

A

In a healthy dog do up diagnostics with radiographs, bloods then check again later.
With mild clinical signs do radiograph, put of Frusemide (for pulmonary oedema) with ACEI (opposes RAAS)., good diet, Na restriction.
Severe clinical signs - oxygen, Frusemide, Pimobendan with ACEI

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11
Q

Why do we give Frusemide with ACEI?

A

To oppose the RAAS to reduce salt & water retention.

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12
Q

What heart condition produces both a systolic and diastolic murmur?

A

Infective endocardiosis. Because it causes insufficient valves.

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13
Q

What are the common bacteria causing infective endocarditis and how do we diagnose this condition?

A

Staphlococcus sp, Streptococcus sp & E. Coli
Diagnose via new/changing heart murmur, fever, blood culture repeatedly every hour (not guaranteed to get bacteriaemia every time).

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14
Q

How can we prevent infective endocarditis and what is the appropriate treatment?

A

Prevent with prophylactic antibiotics in ‘dirty’ surgeries.

Treat with antibiotics (aminoglycoside + beta lactam combo to penetrate fibrin).

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15
Q

How does infective endocarditis occur?

A

Bacteria from body go into endocardium and lodge in valves. Get septic emboli breaking off going to kidneys, brain etc.

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16
Q

What is the usual presentation of a canine cardiomyopathy?

A

Sudden death from congestive heart failure.

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17
Q

What is special about CMO in boxers?

A

Special type of cardiomyopathy called arrhythmogenic right ventricular cardiomyopathy.
>50 ventricular premature contractions in boxers = death

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18
Q

What causes cardiomyopathy?

A

Heart muscle disease or toxins/nutritional.

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19
Q

How do you diagnose cardiomyopathy?

A

ECG - see atrial fibrillation (variable space between R waves and no P waves)
History
Maybe heart murmur
Cardiac cachexia (failure of blood to muscles)
Pulse deficit

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20
Q

What is your expected treatment plan and prognosis for a dog diagnosed with cardiomyopathy?

A

Poor prognosis - death within 3 months.
Put on diuretic to release congestion.
Positive intrope increases heart strength.
ACEI to oppose RAAS and reduce salt & water retention
Pimobendan, ACEI, Frusemide

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21
Q

Describe your radiographically findings for a chronic valvular heart disease case compared with cardiomyopathy case.

A

Chronic valvular heart disease - enlarged LA, enlarged CaVC (compensatory response)
Cardiomyopathy - Generally larger heart, everything enlarged.

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22
Q

What is the dominant heart disease form in cats?

A

Hypertrophic cardiomyopathy

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23
Q

Describe the pathogenesis and clinical signs of feline hypertrophic cardiomyopathy.

A

Thickened LA & LV with narrowing lumen size so muscle hypertrophies and thickens.
Heart has issues with diastole - can’t fill up.
Systolic murmur with or without gallop appears.
Can get saddle thromboembolism where clot in LA goes to aorta causing vasoconstriction.

24
Q

When doing a chest tap where would you position the butterfly catheter?

A

In front of the rib NOT behind due to neurovascular bundle

25
Q

What clinical signs do you associated with saddle thromboembolism in a feline?

A

From a clot in LA goes to aorta and causes vasoconstriction.

26
Q

What are the main congenital heart defects?

A

PDA - Patent ductus arteriosus
Subaortic stenosis
Pulmonic stenosis

27
Q

How do we diagnose and prevent congenital heart defects?

A

Prevent with good breeding

Diagnose with history, examination, chest radiographs, echo.

28
Q

What do you see and hear with a puppy with patent ductus arteriosus?

A 
Female small breed dogs with continuous machinery murmur. 
Hyperkinetic pulse (bigger & stronger) 
See '3 knuckles' on radiograph VD (aortic arch, pulmonary artery & auricle).
29
Q

What is PDA and how would you choose to treat it?

A

Aorta and pulmonary artery are connected.

Treat with surgery catheter based occlusion with coils that form thrombus and block the PDA.

30
Q

Large breed puppy comes in 3 months old. Has a weak rising pulse and extremely loud systolic mumur. Has had some exercise issues.

A

Subaortic stenosis.
Stenosis just below the valve causing concentric hypertrophy left heart pressure overload.
Treat with a beta-1 blocker like atenolol

31
Q

Bulldog comes in 4 years old. Poor exercise tolerance and a left base systolic murmur.

A

Pulmonic stenosis.

Get right ventricular hypertrophy big right sided heart and pulmonary artery bulging. Get a reverse D shaped heart.

32
Q

What condition do you get 3 knuckle heart appearance on radiograph?

A

PDA - patent ductus arteriosus.

The ‘knuckles’ are aortic arch, pulmonary artery & auricle.

33
Q

What condition do you get a reverse D shaped heart?

A

Pulmonic stenosis. Massively enlarged right heart. with pulmonary artery bulge. DDx heartworm.

34
Q

On pericardiocentesis you get yellow colour fluid followed by shiraz/wine coloured fluid. What does this indicate?

A

Pericardial effusion.

Pericardial sac filled with blood.

35
Q

How do you diagnose a pericardial effusion?

A

Cardiac tamponade
Do pericardiocentesis.
Mesothelial cells (look like cancer)
Looks like cardiomyopathy radiographically

36
Q

What is the blood volume of a 65kg dog?

A

90-100mL/kg

So 6.5L blood volume.

37
Q

What do you see when a dog has heartworm disease?

A

Enlarged pulmonary artery & vessels

Microfilaria can outlive parents.

38
Q

What is the most common cardiac tumour?

A

Haemangiosacoma on right auricle. Check the spleen too.

39
Q

What do P waves, QRS complex and T wave exhibit?

A

P wave - atrial depolarisation
QRS - ventricular depolarisation
T- ventricular repolarisation

40
Q

Do you know how to calculate heart rate from ECG?

A

I hope so

41
Q

You count 1 beat in 15 squares on an ECG. Each square is measuring 0.1 seconds. What is the heart rate?

A

1 x 4 = 4 beats per 60 seconds
4 x 10 = 40 beats per minute.
Because 10 squares = 1 sec and 15 squares = 1.5 sec

42
Q

How do you approach an ECG?

A 
Artifacts
Heart rate high or low? 
Rhythm 
Tachycardia or bradycardia? Paroxysmal? 
Is every QRS followed by P and vice versa? 
Are QRS normal?
Complexes early or late? 
Do heights help you?
43
Q

What will you see on an eCG with atrial fibrillation?

A

All QRS are upright and narrow.
No P waves
Irregularly irregular
Variable RR intervals

44
Q

Define heart failure.

A

Failure of the heart to meet the demands of the body.

45
Q

What is a common clinical sign of left sided heart failure in dogs? What about cats?

A

Dogs & cats - pulmonary oedema

46
Q

8yo cat cold hindlimbs, no femoral pulse, cyanotic footpads and gallop heart rhythm. What is an explanation?
What is a gallop rhythm and what causes it?

A

Saddle thromboembolism - emboli from pulmonary artery has broken off and lodged in the aorta. Causes vasoconstriction and loss of blood flow to hindbody.
Gallop rhythm - due to stiff ventricle when the blood enters hear extra sound. Usually from cardiomyopathy.

47
Q

Why do dogs with left sided heart disease often cough before pulmonary oedema has developed?

A

Enlargement of the left atrium puts pressure and presses on bronchus.

48
Q

What is a jet lesion?

A

Turbulent blood flow through the valves causes strips of fibrosis & roughening.

49
Q

What happens to the morphology of the heart as a consequence of severe subaortic stenosis?

A

Get concentric hypertrophy.
Left side heart pressure overload.
Very harsh murmur (can even feel in carotid).

50
Q

Why does atrial fibrillation develop in dogs with mitral dysplasia?

A

Atrium enlarges & stretches and remodels. Going to mess up all the electrical conductance.

51
Q

How do you manage a dog with pulmonary oedema and ruptured chordae tendinae?

A

Frusemide & ACEI as a diuretic and to oppose RAAS.
If more severe use Pimobendan with ACEI.
Get ruptured chordae tendinae from no chance of remodelling

52
Q

Why do you use ACEI in treating heart disease?

A

Use in combo with diuretic/positive inotrope drugs like Pimobendan or Frusemide.
It decreases blood volume, lowers BP and reduces RAAS.

53
Q

Why do you use Pimobendan?

A

Use in heart failure especially in severe valvular heart disease.
Positive inotrope & vasodilator - reduces hearts workload &regurgitation amount

54
Q

Why don’t you use digoxin? When would you use it?

A

Cardiac toxicity and causes inappetance & vomiting.

Only in combo with other drugs to treat supra-ventricular arrhythmias.

55
Q

13yo Doberman 38kg. Coughing and shortness of breath for a month or so. Was given Prednisolone and Tussigon (cough suppressants). Coughing more and low energy levels. What are you thinking?

A

Dilated cardiomyopathy.
Accompanied with pulmonary oedema. Heart remodels and gets too big.
Pleural effusion could also occur - left & right heart failure combination.

56
Q

Siamese male 8yo cat. History of vestibular dysfunction, cataracts and taurine deficient.

A

Siamese have breed predisposition for dilated cardiomyopathy.
Taurine responsive dilated cardiomyopathy.
Do blood taurine and radiograph.

Canine/Feline Internal Medicine (9 decks)

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