Cardiovascular disease

Question 1

In case of cardiovascular disease, what history would you focus on?

Answer 1

fatigue, excercise intolerance, dyspnea, tachypnea, ascites, syncope?

general condition

Question 2

To what could point dyspnea/tachypnea?

Answer 2

pulmonary edema (left sided heart failure), thoracic fluid accumulation (right sided heart failure, in cats due to left sided heart failure)
anemia
respiratory disease, thoracic disease
metabolic causes

Question 3

Respiratory rate in dogs?

Answer 3

in clinic, at rest <20/min
at home, at rest <30/min
at home sleeping <25/min

Question 4

Respiratory rate in cats? see minivetguide!!

Answer 4

in clinic, at rest variable between 30-100
at home, at rest at 15-30
at home sleeping <20

Question 5

What can point us to upper respiratory tract issues?

Answer 5

loud respiration, goose honk like cough (cough receptors in larynx, trachea, bronchi

Question 6

Ascites causes??

Answer 6

Right sided heart failure (mostly dogs)
hypoproteinemia
peritonitis
neoplasma
liver cirrhosis
thrombosis
bleeding etc

Question 7

subcutaneous edema?

Answer 7

usually not due to heart failure in small animals, rarely in large dogs

Question 8

Further examinations in cardiovascular system?

Answer 8

thoracic radiography
echocardiography
ECG
Blood pressure measurement
Blood test: ANP BNP; troponin, endothelin
Phonoechocardiography
cardiac catheterization
serology

Question 9

location of heartbeat?

Answer 9

over the edge of the sternum left side: 3-6 ICS, right side: 3-5ICS; influenced by strength of beat

Question 10

dislocation of heartbeat can be caused by?

Answer 10

tumor, abscess, pneumothorax, hernia, malformation

Question 11

Alteration of cardiac sounds - how?

Answer 11

FRIDA!!

Frequency
Rythm
intensity
demarcation: the 1. and 2. sound can be distinguished
adventitious sounds

check pulse while counting heartrate

Question 12

Rythm of heartsounds can be distinuished in? LOOK UP IN MINIVET GUIDE

Answer 12

normal, regular: respiratory arrythmia: slower during expiration
regular irregular
irregular

Question 13

Demarcation of heart sounds - what can be heard?

Answer 13

Galopp sound: 1.2.3.; 4.1.2. in cardiomyopathy
splitting of heart sounds: the 2. heart sound (different time of closure of aortic and pulmonary valve - cor pulmonale causing increased pulmonary arterial pressure

Question 14

How can we classify murmurs?

Answer 14

Endocardial murmurs: morphological origin, location, intensity,, relation to cardiac cycle, pitch - valve or septal deformities, vessel malformations
Extracardial murmurs: pericardial or pleuopericardial: frictional rubbing
compression test: does the pleurocardial rubbing disappear if the breathing stops?

Question 15

systole?

Answer 15

contraction

Question 16

diastole?

Answer 16

relaxation

Question 17

how to classify endocardial murmurs?

Answer 17

points of maximal intensity?
heart base or apex?
systolic/diastolic/systolic and diastolic?
frequency: low, medium, high or with a pitch
continous, crescendo, decrescendo
conduction?

Question 18

Puncta maxima in the dog?

Answer 18

left side:
Pulmonary: 3rd-4th
AOrta 4-5th intercostal space
Mitral valve 5 intercostal space

right side: tricuspid valve: 4th intercostal space

Question 19

Grading of murmurs?

Answer 19

I: very soft, only heard in quiet room
II: soft but easily heard on direct auscultation
III: moderate intensity with good audiblity
IV: loud murmur, very good audible; no precordial thrill
V: very loud murmur with precordial thrill
VI: loudest murmur