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Smith LA Medicine > Ch 30 Cardio > Flashcards

Ch 30 Cardio Flashcards

1
Q

Can a QRS complex character in large animals reflect chamber enlargement?

A

NO. not sensitive or specific for ventricular enlargement

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2
Q

Why is peak blood flow in large animals with valvular heart disease difficult to estimate?

A

Because optimal doppler signals are obtained with the ultrasound beam parallel to the blood flow being evaluated. Thus the peak velocity is underestimated

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3
Q

What is the sedative of choice for large animals undergoing an ECG?

A

Acepromazine, given ahead of time

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4
Q

What is the most commonly reported congenital cardiac defect in large animals?

A

Ventricular septal defect. This can be evaluated appropriately with doppler

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5
Q

Cardiac and great vessel catheterization can determine what data?

A

-Pressure and waveforms
-Oxygen tension, saturation, content
-cardiac output

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6
Q

What does PAWP assess?

A

Pulmonary artery wedge pressure assesses left atrial mean pressure, left ventricular function, and fluid therapy

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7
Q

Describe a VSD’s character in 1-2 sentences

A

Loud, grade 4-6 plateau pansystolic murmur with PMI in tricuspid area. Murmur on the L has a PMI at the pulmonic valve area.

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8
Q

What are the characteristics of an innocent flow murmur of neonates?

A

-Crescendo-decrescendo shape
-PMI L heart base
-lack of radiation
-low-moderate intensity

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9
Q

What valvular insufficiency do horses with VSD often develop later in life?

A

Mitral regurgitation

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10
Q

What clinpath abnormality would indicate a complicated VSD?

A

polycytemia

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11
Q

Pressure increases in which chambers in animals with VSD indicate cardiac failure?

A

Increased pressure in the left or right ventricles during diastole

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12
Q

Horses with what size of VSD can still race successfully?

A

VSD must be </= 2.5 cm

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13
Q

What VSD to aortic root ratio in nonracing horses and ponies is likely hemodynamically benign?

A

ratio < 0.3

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14
Q

What metrics of a VSD would indicate reduced life expectancy and tendency to develop CHF?

A

Defect > 3.5 cm, VSD/AR ratio 0.64, peak shunt velocity < 3.5 m/s

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15
Q

What are classic signs of a PDA on cardiac auscultation?

A

-continuous machinery murmur
-loudest at L ICS 3-4 at point of shoulder level (can be heard on L or R)
-Bounding arterial pulses due to runoff of blood from systemic to pulmonary circulation
-Murmur intensity increases with exercise, excitement, inc HR

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16
Q

In foals, a PDA normally closes by what time after birth?

A

96 hours

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17
Q

What physiologic “pressures” usually make a PDA close shortly after birth?

A

-lowered pulmonary vascular resistance
-increased systemic resistance
-increased blood volume
-increased left ventricular pressure

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18
Q

A right to left shunt occurs due to what pressure balances/imbalances?

A

When pulmonary resistance equals or exceeds systemic vascular resistance

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19
Q

What are the components of Tetralogy of Fallot? What does Pentalogy include?

A
  1. Overriding aorta
  2. VSD
  3. Obstructed pulmonary arterial flow
  4. 2* R ventricular hypertrophy
  5. ASD or PDA
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20
Q

Cyanosis is noticed when ______ g/dL of hemoglobin are reduced/unoxygenated

A

> 5

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21
Q

What common ER treatment for respiratory distress is unhelpful in patients with R to L shunts?

A

Oxygen administration

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22
Q

What clinpath abnormalities may be seen in animals with Tet or Pent of Fallot?

A

Increased PCV, RBC, and polycytemia

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23
Q

A client has a yearling with tetralogy of fallot. she wants to know, is this condition heritable?

A

No. Or at least no evidence yet to say that

24
Q

How does an atrial septal defect usually sound on auscultation?

A

holosystolic, crescendo-decrescendo at the left heart base (because more volume is being ejected across the pulmonic valve)

25
Q

What abnormalities are associated with tricuspid valve atresia in foals?

A

Patent foramen ovale, small R ventricle, large L ventricle, large mitral valve orifice

26
Q

Which clinical sign would help distinguish persistent truncus arteriosis from VSD or PDA?

A

Cyanosis

27
Q

Persistence of what structure can cause esophageal compression?

A

Right aortic arch or double aortic arch

28
Q

What abnormalities are part of the Eisenmenger complex?

A

VSD, overriding aorta, dilated pulmonary trunk

29
Q

What is your top differential for an older horse with recent-onset machinery murmur that is loudest on the right? What if the horse was a Friesian?

A

Aorticocardiac fistula. In Friesians, suspect aortopulmonary fistula

30
Q

What cardiac changes might you hear in a foal whose PDA has closed? For how long would you expect to hear this?

A

Loud systolic ejection murmur at the L heart base. May persist for 2-3 mo

31
Q

What are the most common bacterial isolates from equine and bovine endocarditis?

A

Equine: Streptococcus, Pasturella
Bovine: Actinobacillus or Trueperella pyogenes

32
Q

In general, how do valvular murmurs sound?

A

Radiating from the PMI in the direction of the ABNORMAL blood flow, coarse and band-shaped, crescendo or musical/honking is systolic, and diastolic are decrescendo and blowing/dive-bomber sounding. Usually moderate-loud

33
Q

In which type of valvular equine murmur is murmur intensity a reliable indicator of lesion severity?

A

Tricuspid regurgitation. Longer, louder murmurs = larger jet

34
Q

Mumurs of which outflow valves are most common in cattle vs horses?

A

Equids: aortic regurgitation
Cattle: pulmonic regurgitation secondary to bacterial endocarditis

35
Q

What signs distinguish murmurs due to ruptured mitral valve chordae tendinae?

A

-Widely radiating, musical sound
-Honking sound or band-shaped pansystolic murmur
-Acute hemodynamic collapse
-Respiratory signs
Pulmonary edema

36
Q

What qualities would be characteristic of a mitral valve prolapse?

A

Crescendo midsystolic to late systolic or holosystolic murmur over the mitral valve area

37
Q

____ is an echocardiographic indicator of increased severity of the aortic regurgitation

A

Decreased aortic root diameter during diastole

38
Q

Which condition of horses is most closely associated with (causes) tricuspid valve bacterial endocarditis?

A

Septic jugular vein thrombophlebitis

39
Q

What causes and contributes to cor pulmonale in cattle?

A

Primary cause: altitude/high mountain disease (hypoxic vasoconstriction) lead to pulmonary hypertension and RV hypertrophy/dilation or failure. Worsened by pneumonia, lungworm, prolonged cold exposure, and by ingesting Locoweed (Astragalus and Oxytropis)

40
Q

What causes tricuspid regurgitation in cor pulmonale?

A

right ventricular dilation due to R sided failure

41
Q

What common sign of respiratory disease is NOT commonly present with cor pulmonale?

A

Pleural or pericardial effusion

42
Q

Which echocardiographic finding is relatively sensitive for pulmonary hypertension?

A

Pulmonary artery dilation

43
Q

Which conditions/characteristics predispose cattle to developing HMD?

A

Living at altitudes > 6000ft, genetics unused to altitude, younger age of animal, ingesting Oxytropis and Astragalus spp plants, cold weather, ionophores in feed

44
Q

Cattle with pulmonary arterial pressure values of _____ are suitable for grazing at altitude?

A

PAP < 41 at over 5000 ft elevation. If at > 49, they are at greater risk

45
Q

What are the recognized bacterial causes of myocarditis? Viral? Parasitic?

A

Bacterial: Staph aureus, Strep equi, Clostridium chauvoei, and Mycobacerium spp
Viral: EVA, EIA, equine influenza, African horse sickness, FMD
Parasitic: strongylosis, onchocerciasis, toxoplasmosis, cystercercosis, sarcosystic infection

46
Q

Ingestion of what agents is associated with development of cardiomyopathy?

A

Monensin, lasalocid, salinomycin, gossypol, Cassia occidentalis, Phalaris spp., molybdenum excess,
Bonus: Acer family plants cause myocardial injury

47
Q

What mineral/vitamin derangement are associated with cardiomyopathy?

A

Selenium and vitamin E defic, Cu deficiency, excessive molybdenum, high sulfates.

48
Q

During what part of the production cycle are cattle most at risk of developing dilated cardiomyopathy?

A

Within 3 months of calving

49
Q

What is the toxic component from Acer spp plants?

A

Hypoglycin A.

50
Q

Which chemistry enzymes change with monensin toxicosis?

A

CK and LDH elevate

51
Q

If a cow presents with signs of myocardial disease, what should she be tested for?

A

Serum: leukosis virus, alpha tocopherol, glutathione peroxidase, and copper concentrations
Whole blood: selenium,

52
Q

Hemoglobinuria concurrent with cardiomyopathy suggests which differential diagnoses?

A

Monensin, gossypol, nutritional myodegeneration,

53
Q

What echo changes are seen in animals with sustained VT and decreased cardiac output?

A

Small LV internal diameter, thickened LV free wall and interventricular septum, small aortic root diameter, decreased FS

54
Q

What change is seen on echo that can differentiate hypertensive cardiomyopathy from sustained VT?

A

increased relative mean wall thickness and RV free wall, as well as decreased myocardial function

55
Q
A

Smith LA Medicine (12 decks)

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