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Animal Diseases > Cardiovascular Diseases > Flashcards

Cardiovascular Diseases Flashcards

1
Q

What is the primary function of the heart

A

To pump blood throughout the body

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2
Q

What is the amount of entering the heart called

A

Preload

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3
Q

What is the amount of blood exiting the heart called

A

Afterload

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4
Q

True or false

Preload should equal afterload

A

True

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5
Q

Why should preload equal afterload

A

To ensure proper tissue perfusion

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6
Q

If more blood is trying to enter the heart than is leaving, what can happen

A

A damming effect that causes higher pressure “upstream” (preload problem)

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7
Q

If there is insufficient blood being pumped out of the heart what can occur

A

A lack of tissue perfusion

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8
Q

What does a lack of tissue perfusion mean

A

Tissues do not receive adequate oxygen and nutrients and removal of waste products will be impaired

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9
Q

What 2 things result from the heart being unable to pump properly

A

Decreased flow to peripheral tissues (decreased afterload)

Increase in preload which causes hypertension (can back up into the lungs)

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10
Q

Describe when heart disease is classified as primary

A

When something goes wrong with the heart itself

Not from recurrent/pre existing disease

Can be congenital or inherited, traumatic or degenerative

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11
Q

Describe when heart disease is classified as secondary

A

When something goes wrong elsewhere in the body that either spreads to the heart it puts strain on the heart

Less common

Often due to underlying pathology

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12
Q

What are some examples of underlying pathology than can cause cardiac disease

A 
Hyperthyroidism 
Renal disease
Neoplasia 
Infection
Parasites 
Toxicity
Metabolic effects 
Lung disease 
Over hydration
Peridontal disease
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13
Q

What is hardware disease in LA and how can you prevent it

A

Accidental ingestion of hardware (nails) in hay

Put magnets in the reticulum to collect them

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14
Q

What does the prognosis of cardiac disease depend on

A

Cause and severity of damage

Descreases once clinical signs are present

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15
Q

If cardiac disease is left untreated it will lead to

A

Heart failure

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16
Q

What are the top 3 common cardiac disease in vet medicine

A

Mitral valve insufficiency (dogs and horses)

Hypertrophic cardiomyopathy (cats)

Endocarditis (cattle)

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17
Q

Most of the time, cardiac disease occurs in ____ animals due to degenerative changes

A

Older animals

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18
Q

Cardiac disease in young animals are often from ____ issues

A

Congenital

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19
Q

What breeds are more susceptible to heart disease

A

Cavalier king charle spaniel
Doberman
Boxer
Manecoon

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20
Q

What are the priority presenting concerns for heart disease from owners

A

Decreased energy (exercise intolerance, weakness, lethargy)

Coughing

Syncope

Open mouth breathing in cats

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21
Q

When is coughing more common

A

At night and in dogs

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22
Q

What is syncope

A

Fainting due to lack of blood flow to the brain (afterload problem)

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23
Q

Owners may not notice changes in early stages of heart disease, so it is often discovered during

A

Annual exams

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24
Q

What are usually two of the earliest signs of heart disease

A

Arrhythmias

Murmurs

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25
Q

What is an arrhythmia

A

Abnormal or irregular rhythm of heart beats

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26
Q

What is tachycardia

A

Increased heart rate

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27
Q

What is bradycardia

A

Decreased heart rate

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28
Q

How are arrhythmias diagnosed

A

Auscultation

Electrocardiogram (ECG)

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29
Q

What is a sinus rhythm

A

A normal arrhythmia due to changes in respiration

Increases with inspiration and decreases with expiration

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30
Q

What is a murmur

A

Abnormal heart sounds

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31
Q

The “whooshing” sound of murmurs are caused by ____ as the blood flows through the heart

A

Turbulence

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32
Q

Turbulence usually occurs around a

A

Valve

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33
Q

True or false

The presence of a murmur always means there isn heart disease

A

False

It only tells you there is turbulence

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34
Q

How are murmurs described

A

Subjective

How loud they are

Where they are heard the loudest (left or right)

If the murmur is associated with systole or diastole

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35
Q

What is the point of maximal intensity (PMI)

A

Where a murmur is heard the loudest over the chest

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36
Q

How are murmurs graded

A

Subjective Grades 1-6

1= easy to miss 
2= faint
3= easy to detect
4= very easy to detect with stethoscope
5= can palpate through chest wall
6= you can heart it without stethoscope
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37
Q

What is the most important thing to know with murmurs

A

How it changes over time

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38
Q

How do you diagnose a murmur

A

Echocardiogram (ultrasound) (most accurate)

Radiographs

Electrocardiogram

Blood pressure

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39
Q

True or false

Dilated cardiomyopathy is acquired

A

TRUE

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40
Q

Describe what happens to the heart is dilated cardiomyopathy (DCM)

A

Muscle of the heart weakens over time, causing the heart to become stretched, flabby and weak.

Outline of the heart becomes larger and rounded and the ventricles are enlarged

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41
Q

True or false

The right side fo the heart is usually affected first in DCM

A

FALSE

it is the left side that is affected first

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42
Q

What happens due to the weakened heart in DCM

A

The conductive fibers of the heart become spread out and lose the ability to coordinate muscle contraction

Cardiac vessels become spread out and cause less tissue perfusion

Decreased stroke volume = less peripheral perfusion

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43
Q

What are some clinical signs of DCM

A 
Weakness
Lethargy
Exercise intolerance 
Coughing
Syncope 
Sudden collapse or death
44
Q

True or false

Dogs with DCM often dont show clinical signs until they are already in heart failure

A

True

45
Q

What is the goal of treatment for DCM

A

Increases the strength of the heart muscle contraction to increases contractility and cardiac output

to decrease the heart rate to prevent exhaustion

46
Q

True or false

There is a cure for DCM

A

False

You can only treat and prolong death

47
Q

What is the prognosis of DCM

A

Poor

The disease is progressive and you cannot reverse the heart muscle damage

Will die from lack of tissue perfusion, heart muscle exhaustion or it will progress to congestive heart failure with pulmonary effusion

Sudden death often occurs

48
Q

Why was DCM the most common cardiac disease in cats in the 1980s

A

Because of cat diets did not contain taurine

49
Q

Why is taurine important in cats diets

A

Taurine is an essential amino acid that cats cannot produce on their own and must get from their diet

50
Q

Where is taurine found

A 
Raw meat
Commercial cat foods (200-250mg/day) 
Birds
Seafood
Insects
51
Q

What is DCM usually associated with in dogs that are typically not predisposed to it

A

Legumes or potatoes, peas or lentils, used as the main ingredient

Could be connected to taurine

52
Q

What is hypertrophic cardiomyopathy (HCM)

A

Abnormally increased growth of the heart muscle

53
Q

Describe what causes HCM as a primary disease

A

Inherited primary condition in cats

Abnormal myosin or abnormal calcium transporters in heart cells

54
Q

What are some diseases that cause secondary HCM

A

Hyperthyroidism

Causes of high blood pressure

Primary mitral valve insufficiency (causes heart muscle to thicken)

55
Q

Describe the pathology of hypertrophic cardiomyopathy

A

Concentric thickening of the walls

Muscles thinkens inwards (starts in the left ventricle)

Ventricles chambers become smaller

Decreases stroke volume (heart can hold less blood)

Decreases tissue perfusion

Blood backs up into the lungs (if hypertrophy of the left ventricle) (pulmonary hypertension, pulmonary effusion, pleural effusion) decreases ability to breath

Blood backs up into the vena cava and liver (causes abdominal effusion)

Heart has to pump faster to make up for decreased volume (heart muscle gets even thicker) increases risk of clots

Can develope saddle thrombi in cats

56
Q

What are the presenting complaints by the owners in HCM

A 
Syncope
Exercise intolerance 
Open mouth breathing
Swollen bellies and limbs 
“Ain’t doing right”
Sudden collapse 
Hind end weakness or paralyzed
57
Q

What are the clinical signs of HCM upon physical exam

A 
Murmurs 
Arrhythmia (tachycardia)  
Dyspnea 
Crackles in the lungs 
Open mouth breathing 
Cyanosis 
Swollen abdomen
58
Q

What are the 3 most clinically emergent signs

A

Sudden collapse
Hind end weakness or paralyzed
Open mouth breathing (cyanosis)

59
Q

Why should you never stress an animal with HCM out

A

The increased heart rate can kill them

60
Q

What are the goals of treatment for HCM

A

Treat underlying primary disease

Decrease contractility and rate to decrease work effort

Keep blood pressure down (to prevent pulmonary edema and pleural effusion)

Treat/prevent thromboemboli in cats

Avoid stress

61
Q

What is the prognosis of HCM

A

Very poor

Most die of asphyxiation or heart muscle failure

62
Q

Define effusion

A

Fluid in 3rd spaces

63
Q

What is pulmonary edema

A

Fluid accumulates in the alveoli. Prevents oxygen uptake

Most common cause is hypertension

64
Q

What is plueral effusion

A

Fluid in the space around the lungs, prevents filling with air

65
Q

What is abdominal effusion

A

Fluid in the abdominal free space

66
Q

What is ascites

A

Clear fluid in the abdominal space from blood vessels

Common cause is hypertension

67
Q

Valvular disease can be a primary condition due to

A

Congenital valve defects and mitral valve insufficiency

68
Q

Valvular diseases can be secondary to disease such as

A

Bacterial endocarditis from a primary infection elsewhere in the body

69
Q

Bacterial endocarditis is a common complication of

A

Hardware disease and rumenitis in cattle and dental disease in all species

70
Q

What is endocardiosis

A

A disease where the valves are thickened and distorted

Usually due to degenerative changes

Neither infection or inflammation are involved

71
Q

What is endocarditis

A

Inflammation of the endocardium (inner lining of the heart including chambers and valves)

72
Q

What is valvular endocarditis

A

Endocarditis specifically involving the heart valves

Due to any cause

Inflammation is present

73
Q

What is bacterial endocarditis

A

Endocarditis caused by bacterial infection of the heart valves

74
Q

What is the pathology of mitral valve insufficiency (or mitral valve endocardiosis)

A

Degenerative disease -Occurs through natural wear and tear

The mitral valve thickens and stiffens (become rough and thick due to fibrotic tissue)

Valves stop closing properly and leads to back flow from the LV into the LA

75
Q

What are the initial effects of mitral valve insufficiency

A

Increased pressure in the left atrium causes LA enlargement

Less filling into the LV, LV has to work harder to move the same amount of blood

76
Q

What are the long term effects of mitral valve insufficiency

A

If there is enough pressure in the LA, pressure backs up into the lungs (pulmonary edema: increased RR, coughing)

Because LV is working harder, it leads to secondary HCM

77
Q

If left long enough, mitral valve insufficiency will lead to

A

Left sided congestive heart failure

78
Q

What is mitral valve regurgitation

A

Backflow or leaking of blood into the left atrium

79
Q

Who is mitral valve insifficiency more common in

A

Dogs, horses

Small breeeds, and older dogs

80
Q

What are the clinical signs of mitral valve insufficiency

A

Very subtle murmur (becomes louder with time)

Exercise intolerance

Tachycardia

Wet cough

81
Q

When is the heart considered to be in heart failure

A

When the heart is unable to pump out enough blood to meet the body’s needs

82
Q

True or false

All forms of cardiomopathy, valvular disease and/or hypertension will eventually lead to heart failure

A

True

83
Q

True or false

Heart failure is not progressive

A

False

It is always progressive

84
Q

What are the ways heart failure is classified

A

Subclinical vs clinical vs congestive

Left sided or right sided

Degree of signs (stages 1-4)

85
Q

What happens in congestive heart failure

A

As the heart begins to fail, the amount of blood leaving the heart decreases than what is entering

Results in less tissue perfusion and back up of blood into the peripheral or lungs

86
Q

What is subclinical heart failure (AKA asymptomatic heart failure)

A

Has compensatory mechanisms to help maintain blood pressure and tissue perfusion (vasoconstriction, water retention, increased heart rate)

No clinical signs

Heart is unable to pump effectively

Life long disease

87
Q

When do you start to treat subclinical heart failure

A

When you see heart enlargement on radiographs

88
Q

When does subclinical heart failure progress to clinical heart failure

A

When compensatory mechanisms are not sufficient enough to maintain blood pressure to tissues and organs

And eventually begins to show signs

89
Q

What is clinical heart failure

A

Occurs as soon as the patient shows sigsn (exercise intolerance, dyspnea, cough)

No longer has compensatory mechanisms

90
Q

What is the pathology of clinical heart failure due to decreased output (after load) which leads to decreased tissue perfusion

A

Less cardiac output results in decreased blood pressure and decreased tissue perfusion

This predisposes patient to:
Kidney damage
Syncope
Exercise intolerance and weakness

91
Q

What is the pathology of clinical heart failure due to increased input (preload) (blood backs up before the heart)

A

Blood backs up into the ventricles, into the atria, and into the vessels

Causes hypertension

If BP is high enough, fluid is pushed out of the capillaries and into the interstitial space (now considered congestive heart failure)

If interstitial volume is exceeded, fluid enters 3rd spaces (alveoli, pleural space, abdominal space, SQ space)

92
Q

Where fluid ends up in heart failure depends on

A

Which side of the heart is failing

Left: lungs

Right: body

93
Q

What happens in left sided congestive heart failure

A

The left ventricle cannot pump blood out effectively, so blood backs up into the left atrium, then the pulmonary vein, then capillaries of the lung and then alveoli

Thisnis pulmonary EDEMA (fluid in the lungs)

94
Q

What does pulmonary edema prevent

A

Prevents Air exchange and the animal essentially suffocates/drowns from the inside out

95
Q

Excess fluid in the lungs can eventually get pushed out to the plueral space, what is this known as

A

Pleural effusion (fluid in the plueral space/around the lungs)

96
Q

What does plueral effusion prevent

A

Prevents the lungs from expanding

97
Q

What are the clinical signs related to decreased tissue perfusion and effects on breathing in left sided congestive heart failure

A

Open mouth breathing

Short breaths

Increased respiratory effort (abdominal, rapid, shallow)

Can only breath easily when standing (they resist lying down)

Cyanosis

98
Q

What happens in right sided congestive heart failure

A

The right ventricle cannot pump blood out effectively, blood backs up ino the right atrium, then the vena cava, then the liver

Fluid accumulates in the liver

99
Q

What happens in right sided congestive heart failure if fluid exceeds the interstitial volune

A

The fluid will move into the abdominal space, called abdominal effusion

100
Q

What is abdominal effusion also known as

A

Ascites

101
Q

What are the clinical signs related to hypertension in the systemic venous return in right sided congestive heart failure

A

Abdominal distension (peritoneal effusion) (pot bellies)

Jugular vein distension (common in cattle)

Liver enlargement (fluid in liver) and signs associated with liver failure

Edema in SQ, limbs, brisket

Cachexia (wasting)

102
Q

What is it considered if both sides of the heart fail

What signs would you see

A

Generalized heart failure

Signs associated with both right and left sided heart failure

103
Q

What is the prognosis for heart failure

A

Guarded

This is a progressive disease -rate of progression depends on the patient

This will eventually lead to death

104
Q

What are the main reasons heart failure will lead to death

A
  1. Output failure (organ failure, circulatory shock)
  2. Pulmonary and plueral effusion leading to hypoxia/anoxia
  3. Cardiac infarct (heart attack) due to lack of blood flow to the heart (more common if there are thromboemboli)
105
Q

What is the goal of treatment of heart failure

A

To slow down the rate of progression and treat symptoms

106
Q

What does treatment of heart failure include

A

Rest, restricted activity/excitement (to keep heart calm)

Reduced salt intake: Na increases BP and pulls in water and makes heart work harder

Vasodilators: decreases BP

Diuretics: pee out fluid to decrease BP

drugs to slow down the heart and prevent arrhythmias

Prevent thromboemboli

107
Q

What is another word for heart attack

When does it occur

A

Myocardial infarction

When blood flow to the myocardium is interrupted causing necrosis to the muscle

Animal Diseases (15 decks)

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