Cardiovascular Disease Flashcards

1
Q

What is diastole?

A

The state of the cardiac cycle where the ventricles are relaxed and filling

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2
Q

What is systole?

A

The state of the cardiac cycle where the ventricles are contracting

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3
Q

What is the normal heart rate for a dog?

A

60-180 bpm

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4
Q

What is the normal heart rate for a cat?

A

120-240 bpm

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5
Q

What is a congenital heart disease?

A

A disease which is present from birth

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6
Q

What are some examples of congenital cardiac disease?

A

Aortic or pulmonic stenosis
Patent ductus arteriosus
Ventricular septal defect

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7
Q

What is aortic/pulmonic stenosis?

A

Narrowing of the aortic/pulmonic valves

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8
Q

What are acquired heart diseases?

A

Diseases which present in adult animals

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9
Q

What are some examples of acquired heart disease in dogs?

A

Dilated cardiomyopathy
Pericardial effusion
Myxomatous mitral valve disease

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10
Q

What is a common acquired heart disease in cats?

A

Hypertrophic cardiomyopathy

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11
Q

What are the 2 main types of cardiac arrhythmias?

A

Bradyarrhythmia

Tachyarrhythmia

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12
Q

What methods can be used to diagnose heart disease?

A
History and physical examination 
Blood tests 
Blood pressure 
ECG (+/- Holter monitor) 
Echocardiography
Thoracic radiographs
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13
Q

What is a Holter monitor?

A

24hr ECG

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14
Q

What are the typical presentations for cardiac disease?

A
Incidental finding 
Exercise intolerance and weakness 
Syncopal episodes 
Difficulty breathing 
Sudden death
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15
Q

What specific presentation often results from right-sided heart disease?

A

Distended abdomen

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16
Q

Which factors are important to heck during a physical examination for suspected CV disease?

A
Body condition 
Respiratory rate 
Mucous membranes and CRT 
Jugular vein
Peripheral pulses
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17
Q

What is cardiac cachexia?

A

Loss of lean muscle mass despite good appetite in dogs with CV disease

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18
Q

What could be the cause of distended jugular vein?

A

Right-sided heart disease

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19
Q

What is the normal respiratory rate for a dog?

A

<30 brpm (sleeping)

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20
Q

What happens to the respiratory rate in animals with chronic heart failure?

A

Increases >35-40 breaths per minute

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21
Q

What should you be checking for during heart auscultation?

A

Heart rate
Rhythm
Assess pulses simultaneously
Presence of heart murmurs

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22
Q

Why is it important to check the peripheral pulses alongside heart beat?

A

Assess pulse quality and pulse deficits

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23
Q

What are pulse deficits?

A

Where there is a heart beat heard but no pulse felt

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24
Q

What is a precordial thrill?

A

A very loud heart murmur

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25
Q

What is important to check for when auscultating the lungs?

A

Respiratory rate
Adventitious sounds
Crackles

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26
Q

What are the typical clinical cardiovascular findings when an animal has heart failure?

A
Reduced cardiac output 
Weak peripheral pulses 
Tachycardia 
Pale MM, prolonged CRT 
Heart murmur 
Arrhythmias 
Gallop sounds
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27
Q

In what type of heart diseases are gallop sounds more commonly heard?

A

Myocardial diseases

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28
Q

What are the typical findings with left-sided heart congestion?

A

Pulmonary oedema
Tachypnoea and dyspnoea
Cough

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29
Q

What are the typical findings with right-sided heart congestion?

A

Distended peripheral veins
Ascites
Pleural effusion

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30
Q

What type of blood testing is used for diagnosing CV disease?

A

Haematology
Biochemistry
Cardiac biomarkers

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31
Q

Why is haematology used in diagnosing CV disease?

A

Checking for systemic diseases

Anaemia

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32
Q

What is a haemic murmur?

A

A ‘whooshing’ sound on auscultation because anaemic blood passes through the heart faster

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33
Q

Why is biochemistry used in diagnosing CV disease?

A

Assessing kidney values

Monitoring electrolytes

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34
Q

Which cardiac biomarkers are used when testing for heart disease?

A

Cardiac troponin I (marker for myocardial cell damage)

NT-proBNP (marker for myocardial stretch)

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35
Q

What is the normal systolic BP in a dog?

A

120-140mmHg

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36
Q

Why should you measure blood pressure at the same level as the heart?

A

To give the most accurate measurement

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37
Q

What effect does hypertension have?

A

Increases cardiac workload

Can contribute to progression of disease

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38
Q

What effect does hypotension have?

A

Might indicate decompensated heart failure

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39
Q

How low does blood pressure need to be to be a concern?

A

<80mmHg

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40
Q

Why might you use ECG?

A

To further characterise auscultatory findings (bradycardia, tachycardia, irregular rhythm, pulse deficits)

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41
Q

What are the benefits of using a Holter monitor?

A

Can investigate intermittent arrhythmias (frequency, severity)
Monitoring response to antiarrhythmic therapy

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42
Q

Why might you use echocardiography?

A

To diagnose cardiac disease (plus severity and prognosis)
Monitor progression of disease
Assess treatment options and monitor response to treatment

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43
Q

What are thoracic radiographs indicated for?

A

Cough
Tachypnoea
Dyspnoea

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44
Q

How many views are needed when taking thoracic radiographs?

A

At least 2 - right lateral and dorsoventral

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45
Q

What is cardiomegaly?

A

An enlarged heart (seen on x-ray)

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46
Q

How is heart size measured on thoracic radiographs?

A

Using vertebral heart size

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47
Q

What is the normal vertebral heart size for dogs and cats?

A

Dogs <10.7

Cats <8

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48
Q

Aside from vertebral heart size, what other signs of cardiomegaly can be seen on a radiograph?

A

Elevation of trachea

Increased sternal contact

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49
Q

In what locations can a stenosis form?

A

Subvalvular
Valvular
Supravalvular

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50
Q

How is stenosis of the great vessels diagnosed?

A

Echocardiography

51
Q

Where does an aortic stenosis usually form?

A

Subvalvular

52
Q

What can an aortic stenosis lead to?

A

Left ventricular hypertrophy

Left-sided congestive heart failure

53
Q

Where does a pulmonic stenosis usually form?

A

Valvular

54
Q

What can a pulmonic stenosis lead to?

A

Right ventricular hypertrophy

Right-sided congestive heart failure

55
Q

What are the clinical signs and findings for stenosis of the great vessels?

A
Arrhythmias 
Exercise intolerance 
Syncope 
Congestive heart failure 
(Sometimes asymptomatic)
56
Q

What are the treatment options for stenosis of the great vessels?

A

Beta blockers
Balloon valvuloplasty (pulmonic)
Standard treatment for congestive heart failure

57
Q

What is the effect of beta blockers in the treatment of stenosis?

A

Reduces the amount of work the ventricles have to do

58
Q

What is the ductus arteriosus?

A

Normal fetal connection between pulmonary artery and aorta

59
Q

What does the ductus arteriosus close to form?

A

Ligamentum arteriosum (when take first breaths)

60
Q

What happens as a result of a patent ductus arteriosus after birth?

A

Blood flows from aorta to pulmonary artery

61
Q

What does a patent ductus arteriosus sound like on auscultation?

A

Loud continuous murmur at the level of the left heart base

62
Q

What is the treatment for a patent ductus arteriosus?

A

Interventional closure
Surgical ligation
Congestive heart failure therapy

63
Q

What is a ventricular septal defect?

A

A hole in the ventricular septum

64
Q

What are the symptoms of ventricular septal defect?

A

Usually asymptomatic - most diagnosed defects are small

65
Q

Where is the most common location for a ventricular septal defect?

A

Upper septum, just below aortic valve

66
Q

How loud is a MILD right-sided systolic murmur (with ventricular septal defect)?

A

Loud murmur

67
Q

How loud is a SEVERE right-sided systolic murmur (with ventricular septal defect)?

A

Soft murmur

68
Q

How is a ventricular septal defect diagnosed?

A

Echocardiography

69
Q

How is a ventricular septal defect treated?

A

Usually none necessary

Heart failure treatment if needed

70
Q

What is the life expectancy for an animal with a ventricular septal defect?

A

Normal (if small defect)

71
Q

What causes myxomatous mitral valve disease?

A

It is idiopathic

72
Q

What breed/age are more likely to develop myxomatous valve disease?

A
Small breeds (cavaliers, dachsunds)
Adult onset (7+ years)
73
Q

Which valves are affected in myxomatous mitral valve disease?

A

Mitral and tricuspid

74
Q

How is myxomatous mitral valve disease diagnosed?

A

Echocardiography

75
Q

What happens to the valves in myxomatous mitral valve disease?

A

Thickening of the valve leaflets

Prolapse of valve leaflets into the atrium

76
Q

What happens to blood flow/heart structure as a result of myxomatous mitral valve disease?

A

Regurgitation of blood back into the atrium

Left atrial and ventricular dilation

77
Q

How quickly does myxomatous mitral valve disease progress?

A

Slow progression

Long asymptomatic period, murmur may be incidental finding

78
Q

What type of murmur does myxomatous mitral valve disease cause?

A

Left-sided apical systolic murmur

79
Q

What can myxomatous mitral valve disease progress into if left untreated?

A

Left-sided congestive heart failure

80
Q

What causes dilated cardiomyopathy?

A

It is idiopathic

81
Q

What breeds/age are more likely to suffer from dilated cardiomyopathy?

A

Large breed dogs (doberman, great dane, newfoundland)

Adult onset

82
Q

What type of murmur does dilated cardiomyopathy cause?

A

Left apical systolic murmur

83
Q

What changes in the heart does dilated cardiomyopathy cause?

A

Left ventricular dilation
Decreased systolic function
Arrythmias

84
Q

How is dilated cardiomyopathy diagnosed?

A

Echocardiography

85
Q

What animals are more likely to suffer from pericardial effusion?

A

Large breed adult dogs

86
Q

What are the common causes of pericardial effusion?

A

Idiopathic, neoplasia

87
Q

What effect does pericardial effusion have on the heart function?

A

Fluid in the sac around the heart compromises filling
Decreased cardiac output
Right-sided heart failure (collapses under pressure)

88
Q

How is pericardial effusion diagnosed?

A

Echocardiography

89
Q

How is pericardial effusion treated?

A

Pericardiocentesis

90
Q

How is pericardiocentesis carried out?

A

Mild sedation, left lateral recumbency

3rd-8th intercostal space

Large catheter

Echocardiography used to find best spot

91
Q

How can you check efficacy of pericardiocentesis?

A

Check fluid for clotting/PCV
Measure volume drained
Collect samples for cytology and culture

92
Q

What causes hypertrophic cardiomyopathy?

A

Genetic causes

93
Q

What effect does hypertrophic cardiomyopathy have on heart function?

A

Increased myocardial thickness impairs filling in diastole

94
Q

How is hypertrophic cardiomyopathy diagnosed?

A

Echocardiography

95
Q

What does hypertrophic cardiomyopathy sound like on auscultation?

A

Heart murmur

Gallop sound

96
Q

Which factors in-clinic can precipitate heart failure?

A

stress
anaesthesia
fluid therapy

97
Q

What are the signs of aortic thromboembolism (caused by hypertrophic cardiomyopathy)?

A

Sudden onset lameness
Cold leg
Peripheral cyanosis
Pain

98
Q

What can heart failure be due to?

A

Disease progression

Decompensation of previously stable heart failure

Development of impedance of cardiac filling

99
Q

What is left-sided heart failure?

A

Congestion of pulmonary circulation - pulmonary oedema

100
Q

What are the signs of left sided heart failure?

A

Tachypnoea
Dyspnoea
Pulmonary crackles
Cough (not always)

101
Q

What is right-sided heart failure?

A

Congestion of the systemic circulation

102
Q

What are the signs of right-sided heart failure?

A

Distended peripheral veins
Positive hepatojugular reflux
Ascites
Pleural effusion

103
Q

What is the result of left AND right sided heart failure?

How does it present?

A

Decreased cardiac output

Presents as tachycardia, weak peripheral pulses, slow CRT

104
Q

How might cats with heart failure present?

A

Hypothermia and bradycardia

105
Q

What are the possible treatments for heart failure?

A

Furosemide (diuretic)

Minimise stress
Oxygen

Pimobendan
ACE inhibitor
Spironolactone

Water always available

106
Q

What is the main goal of heart failure treatment?

A

Reduce the circulating volume of blood

107
Q

Why must water always be available to patients undergoing heart failure treatment?

A

Avoiding acute kidney injury

108
Q

What are the target parameters when monitoring patients with heart failure?

A

<40 breaths per min
>100mmHg

Decreased HR
Improved pulse quality and CRT

109
Q

What does this ECG trace show?

A

Normal rhythm

110
Q

What are the different types of bradycardia?

A

Sinus bradycardia
Atrial standstill
AV blocks
Sick sinus syndrome

111
Q

How does 2nd degree AV block appear on an ECG?

A

As non-conducted P waves

112
Q

What does this ECG trace show?

A

2nd degree AV block

113
Q

How does 3rd degree AV block appear on an ECG?

A

As wide and bizarre QRS complexes

114
Q

What does this ECG trace show?

A

3rd degree AV block

115
Q

Where does supraventricular tachycardia originate?

A

From the atria

116
Q

How does supraventricular tachycardia appear on an ECG trace?

A

QRS complexes are narrow

117
Q

What does this ECG trace show?

A

Supraventricular tachycardia

118
Q

How does atrial fibrillation appear on an ECG trace?

A

200+ bpm

Irregular rhythm with no P waves

119
Q

What does this ECG trace show?

A

Atrial fibrillation

120
Q

Where does ventricular arrhythmia originate?

A

From the ventricular myocardium

121
Q

How does ventricular arrhythmia appear on an ECG trace?

A

As wide and bizarre QRS complexes

122
Q

What is shown on this ECG trace?

A

Ventricular arrhythmia

123
Q

What is shown on this ECG trace?

A

Ventricular premature complexes

124
Q

What is shown on this ECG trace?

A

Ventricular tachycardia (HR 375bpm)