Cardiovascular

Question 1

Common acquired heart diseases?

Answer 1

Endocardial/endocardiosis
DCM - dilated cardiomyopathy
HCM -Hypertrophic cardiomyopathy
Mitral valve disease

Question 2

endocardcial/ endocardiosis 
Cause?
Presentation 
clinical signs 
diagnosis 
treatment
Nursing care

Answer 2

Cause:

• Disease of the heart valves due to chronic fibrosis (endocardiosis)
• it prevents the valves from functioning properly and blood regurgitates into the atria increasing the work load this leads to congested and heart failure
• most commonly found heart disease in dogs but rare in cats
• the mitral valve is most commonly affected

Clinical signs: p = presentation

• **if the mitral valve is affected - same as left side heart failure - coughing (p), dyspenoea (p), tachypnoea (p), murmurs, dysrhythmias, exercise intolerance, lethagric (p), pulmonary odeam, cyanosis is severe cases (p)
• ** if the tricuspid valve is affected - same as right sided heart failure - ascites, abdomen distension (p), hepatomegaly, spemomegaly, excercise intolerance, lethargic (p), pale MMs, tachycardia, weak pulses, dyspnoea (p), tachypnoea (p), cyanosis (p), murmurs, dyshythmias (in many cases)

Diagnosis - clinical history, examination, ECG, echocardiography,

Treatment - endocardiosis is treated when heart failure has developed - reduce exercise, weight loss (if needed) (preventive also), low salt diet (preventive also),

• diuretics to relieve oedema and ascites
• ACE inhibitors to decrease up-regulation of fluid retention
• primobending to improve contractility
• anti-arrythmic drugs if required

Nursing care for acute cases 
DO NOT STRESS 
provide 02
cage rest 
keep warm

Question 3

Endocarditis 
causes 
presentation
clinical signs
diagnosis
treatment

Answer 3

This is inflammation of the inside of the heart chambers and heart valves (endocardium) caused by infection

Clinical signs:
pyrexia 
lethargy (p)
shifting lameness (p) 
anorexia (p)
heart murmur 

diagnosis:
History, clincal examination, ECG, echocardiography, blood culture

Treatment
broad spectrum antibiotics until blood culture results

Question 4

explain cardiomyopathies?

Answer 4

these are diseases of the myocardium that are associated with cardiac dusfuction. cardiomyopathy is the most frequently recognized cardiac condition in cats (hypertrophic cardiomyopathy) and large/giant dogs (dilated cardiomyopathy)

Question 5

Hypertrophic cardiomyopathy
Cause 
presentation
clinical signs 
diagnosis 
treatment

Answer 5

Thickening of the heart muscle that interferes with relaxation of the heart preventing normal filling, poor diastolic function, decreased cardiac output and heart failure.
mostly seen in cats secondary to hypothyroidism

Clinical signs:
dysponea (p), tachypnoea (p), tachycardia, heart murmur
common complication is aortic thromboembolism (blood clot leaves the heart and lodges in caudal aorta obstructing blood flow to hind limbs) Clinical signs:
acute onset of uni/bilateral paresis/paralysis of hindlimbs (p), lack of arterial pulse in affected legs, pain (p), hind limbs cool to touch, dysponea (p), tachypnoea (p)

Diagnosis
echocardiograpy, x-rays -lateral and DV views (do not put distressed patients in VD) , ECG, blood pressure, blood test - T4, renal function, hematology, biochemistry, clotting profile. Also abdominal ultrasound

Treatment
the aim is to improve muscle relaxation and slow hear rate using calcium channel blockers to relax blood vessels and increase the supply of blood and oxygen to the heart while also reducing the heart’s workload
Also beta blockers to slow down the heart by blocking the action of hormones like adrenaline
Blood clots are treated with pain relief, antithrombotics and vasodilators

Question 6

dilalted cardiomyopathy
cause 
presentation
clinical signs 
diagnosis
treatment

Answer 6

dilation of the heart chambers and poor sytolic function and heart failure
the heart is enlarged and there is reduced cardiac contractility, decreasing forward blood flow and causing congestion and heart failure
seen frequently in giant dogs - greatdanes, newfoundlands, boxers, etc
in cats maybe idiopathic or due to taurine deficiency (v.rare now)

Clinical signs
acute onset, anorexia (p), lethargy (p), reduced exercise tolerance, left sided heart failure (coughing (p), dysponea (p), tachypnoea (p)) sometimes right sided heart failure, ascites, heart murmur, tachycardia, arrythmias, sudden death.

Diagnosis
ECG,, x-rays, echocardigrapy

Treatment
is case by case i.e severity of disease, patient etc and general same as heart failure acute/chronic

very important not to stress these patients