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Cardiology > Congenital Heart Defects > Flashcards

Congenital Heart Defects Flashcards

1
Q

What is congenital heart disease?

A

Malformations of the heart and great vessels that are present at birth
Caused by altered or arrested embryonic development of the rudimentary heart
○ Leads to potentially gross anatomical alterations

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2
Q

What is an innocent murmur?

A

A heart murmur not caused by underlying heart disease
Caused by:
* High heart rate
* High velocity of blood flow
* Changes turbulence

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3
Q

What is a heart murmur?

A

Abnormal heart sound caused by turbulent blood flow within heart

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4
Q

PMI

A

Point of Maximal Intensity

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5
Q

Signs of an innocent murmur

A

Low grade murmur (1/2)
PMI Left heart base
Mid-systolic
Varying intensity with rate
Minimal radiation
Usually resolve within 6 months

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6
Q

Common abnormalities on clinical exam of congenital heart disease

A

Arterial pulse
○ Hyperkinetic pulse
○ Hypokinetic pulse
Mucous membrane colour
Precordial impulse (palpable)

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7
Q

Causes of hyperkinetic pulse

A

Abnormal diastolic run off of aortic blood
Patent ductus arterioles
Severe aortic regurgitation

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8
Q

Causes of hypokinetic pulse

A

Left ventricular obstruction
Aortic stenosis
Poor LV output

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9
Q

What diagnostics are useful/give clues in diagnosing congenital heart disease?

A

History
CLinicala Exam
ECG
Thoracic Radiographs

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10
Q

What diagnostics are definitive clues in diagnosing congenital heart disease?

A

Echocardiography

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11
Q

Which structures can fail to develop properly?

A
  1. Mitral valve
  2. Tricuspid valve
  3. Aortic valve
  4. Pulmonary valve
  5. Intra atrial septum
  6. Intra-ventricular septum
  7. Ductus arteriosus
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12
Q

Which are the most common congenital heart defects?

A

Aortic stenosis (AS)
Patent ductus arteriosus (PDA)
Pulmonic stenosis (PS)
Ventricular septal defect (VSD)

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13
Q

What is aortic Stenosis?

A

Narrowing of the aorta

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14
Q

What are the types of aortic stenosis

A

Subaortic stenosis
Valvular aortic stenosis
Supra-aortic stenosis

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15
Q

Which is the most common form of aortic stenosis?

A

Subaortic stenosis

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16
Q

Common signalment of subaortic stenosis

A

Boxers
Newfoundlands
Golden retrievers
Syncope
Lethargy
Exertional weakness

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17
Q

What kind of murmur does AS have?

A

Harsh systolic ejection murmur
* Exercise/excitement may increase intensity of murmur
PMI at aortic valve (base of heart
Precordial thrill at left base
Radiates to right base

(May have diastolic murmur depending on severity)

18
Q

Findings of aortic stenosis on echocardiogram

A

Increased speed at which blood crosses aortic valve
* High speed is due to high pressure

Thickening of LV due to high pressure
* Can cause narrowing of LV

19
Q

Treatment for AS

A

Beta-blockers to reduce oxygen demand
* Atenolol
Catheter through femoral artery into stenosis and inflate balloon

If mild, often doesn’t need treatment

20
Q

Types of pulmonic stenosis

A

1 - Infundibular
2 - Sub-valvular
3 - Valvular
4 - Supra-valvular
5 - Anomalous coronary artery

21
Q

Most common type of pulmonic stenosis

A

Valvular
* affects leaflets of annular valve

22
Q

Signalment of pulmonic stenosis

A

Brachycephalics
Terriers

23
Q

Type of murmur in pulmonic stenosis

A

High frequency systolic ejection murmur
PMI left heart base

(Same as AS)

24
Q

Clinical signs of PS

A

RCHF (pleural effusion/ascites)
Syncope
Exercise intolerance
Sudden death in severe cases

25
Q

Findings of PS on clinical exam

A

Prominent R apical beat
PMI of systolic murmur on left heart base
Radiates cranially and ventrally
Prominent jugular pulses

26
Q

Findings of PS on echocardiogram

A

Enlarged right atrium
* Should be significantly smaller in healthy animal

Turbulence in right side of heart

27
Q

Findings of PS on radiography

A

RHS more cranial and enlarged
Very radiolucent lung fields
* Less blood flow to lungs so vascular pattern disappears

28
Q

Treatment of PS

A

Same as AS
Berablockers (Atenolol) to prevent arrhythmias and reduce work of RV

Catheter through femoral artery into stenosis and inflate balloon

29
Q

What is the ductus arteriosus

A

Shunt between aorta and pulmonary artery present in-utero and shortly after birth

Lungs not yet in use

30
Q

What is PDA?

A

Patent ductus arteriosus
Blood shunts from aorta to pulmonary artery
(Leaves LV via aorta, enters pulmonary artery to lungs, returns via pulmonary vein to LA)

Seen in very young animals

31
Q

Describe the PDA murmur

A

Continuous murmur
PMI over left base but very cranial and dorsal (in axilla)
Usually loud

32
Q

Result of PDA

A

Massive LHS volume overload leads to stretched LA and LV
Hyperkinetic pulses

33
Q

Treatment for PDA

A

Surgical
○ Thoracotomy
○ Ligate PDA
○ Major risk of haemorrhage
Occluder
○ Catheter through femoral artery to PDA
○ Disc sits either side and blocks PDA

34
Q

Where are ventricular septal defects most common?

A

High in the membranous part of septum
Just below aortic valve and under tricuspid leaflet

35
Q

What is a VSD?

A

Ventricular septal defect

Allows blood to flow from left to right ventricle
(Higher pressure in left)

36
Q

Result of VSD

A

Flow from left to right ventricle
Basically skipping out aorta

Leads to overload of pulmonary trunk, pulmonary circulation, LA and LV
Moderate/large VSD results in LCHF (Pulmonary oedema)

37
Q

Small VSD findings

A

Very loud systolic murmur
Left base (LA)
Right apex (RV)

Often tolerated well and not an issue

38
Q

What should you do if you find murmur in a puppy/kitten?

A

If grade 3 or below, leave for 6 months and recheck
Loud doesn’t always mean bad
ALWAYS RECCOMEND ECHOCARDIOGRAPHY

39
Q

What is the tetralogy of fallot

A

4 different defects:
* Pulmonic stenosis
* Large VSD
* Right ventricular hypertrophy
* Dextropositioning of aorta

Results in right to left shunt

40
Q

Clinical signs of tetralogy of fallot

A

Cyanosis
Polycythemia
Weakness
Lethargy
Dyspnoea

Cardiology (18 decks)

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