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VET 408: Cardio/Respiratory > Congenital Heart Defects > Flashcards

Congenital Heart Defects Flashcards

1
Q

congenital valve defects

A
  • sub aortic stenosis
  • pulmonary stenosis
  • mitral valve dysplasia
  • tricuspid valve dysplasia
  • cor triatriatum sinsiter/dexter
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2
Q

congenital shunt defects

A
  • PDA
  • VSD
  • ASD
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3
Q

what species/breeds are predisposed to sub aortic stenosis

A

large breed dogs (Goldens, Rottweilers, newfoundlands)

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4
Q

murmur for sub aortic stenosis

A

left basilar systolic ejection murmur

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5
Q

what is the primary lesion in sub aortic stenosis

A

ridge/ring underneath the aortic valve

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6
Q

what are secondary lesions in sub aortic stenosis

A
  • concentric hypertrophy of the LV from pressure overload
  • aortic insufficiency
  • post stenotic dilation of the aorta
  • AV endocarditis
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7
Q

what are signs of subaortic stenosis on echo

A
  • increased aortic outflow velocity
  • thick LV wall
  • fibrosis in LVFW
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8
Q

what treatment is there for sub aortic stenosis

A

B blockers (atenolol) to reduce load/demand on heart

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9
Q

what species/breed is predisposed to pulmonary stenosis

A

small breed dogs, brachycephalics

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10
Q

murmur for pulmonary stenosis

A

left basilar systolic ejection murmur

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11
Q

what is the primary lesion in pulmonary stenosis

A

fusion or thickening of the valve leaflets

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12
Q

what are secondary lesions in pulmonary stenosis

A
  • concentric hypertrophy of the RV from pressure overload
  • pulmonary insufficiency
  • post stenotic dilation of PA
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13
Q

what are signs of pulmonary stenosis on echo

A
  • increased pulmonary outflow velocity
  • RV wall thickening
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14
Q

what is the treatment for pulmonary stenosis

A

beta blockers (atenolol)
+
balloon valvuloplasty

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15
Q

what are the clinical differences between subaortic and pulmonary stenosis

A

SAS murmur has carotid radiation (can be heard in carotid sinuses), PS does not

SAS have weak/delayed pulses, PS has normal pulses

BREEDS
- large: SAS
- small: PS

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16
Q

what species/breeds are predisposed to mitral valve dysplasia

A

RARE in most species

dogs: bull mastiffs, bull terriers, labs
some cats

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17
Q

murmur for mitral valve dysplasia

A

left apical systolic regurgitant murmur

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18
Q

what is the primary lesion in mitral valve dysplasia

A

irregular valve architecture
OR
irregular chordae attachments

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19
Q

what are the secondary lesions in mitral valve dysplasia

A
  • eccentric hypertrophy of the LV from volume overload
  • LA dilation
  • mitral valve insufficiency
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20
Q

what are signs of mitral valve dysplasia on echo

A
  • LA and LV enlargement
  • papillary muscle anomalies
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21
Q

what is the treatment for mitral valve dysplasia

A

no fix - treat the CHF

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22
Q

what species/breed is predisposed to tricuspid valve dysplasia

A

labradors

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23
Q

murmur in tricuspid valve dysplasia

A

right apical systolic regurgitation murmur

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24
Q

what is the primary lesion in tricuspid valve dysplasia

A

irregular architecture
OR
irregular chordae attachments

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25
Q

what secondary lesions are in tricuspid valve dysplasia

A
  • eccentric hypertrophy of the RV from volume overload
  • tricuspid insufficiency
  • RA dilation
26
Q

what are signs of tricuspid valve dysplasia on echo

A
  • RA and RV enlargement
  • papillary muscle anomalies
27
Q

what treatment is there for tricuspid valve dysplasia

A

no fix - treat the CHF

28
Q

cor triatriatum sinister vs dexter

A

sinister: affects the LEFT atrium
dexter: affects the RIGHT atrium

29
Q

what species are predisposed to CT sinister vs dexter

A

sinister: cats
dexter: dogs

30
Q

what is the primary lesion in CT sinister/dexter

A

abnormal vessel entry into the atria

sinister: pulmonary veins enter incorrectly into LA

dexter: caudal vena cava enters incorrectly into RA

31
Q

what is the treatment for CT sinister/dexter

A

balloon valvuloplasty and treat the CHF

32
Q

what species are predisposed to PDA

A

dogs

33
Q

murmur in PDA

A

left basilar continuous murmur

34
Q

what is the primary lesion in PDA

A

incomplete ductal muscle causes failure of DA closure at birth

causes blood to flow from aorta to PA

35
Q

what are the secondary lesions in PDA

A
  • eccentric hypertrophy of the LV from volume overload
  • pulmonary over circulation
  • aortic dilation, possibly PA dilation
36
Q

what are signs of PDA on echo

A
  • visualize the PDA
  • continuous flow from aorta to PA throughout systole and diastole
  • flow peaks velocity during systole
37
Q

what kind of pulses are seen with PDA

A

hyper dynamic (bounding) due to low diastole pressure

38
Q

what is the treatment for PDA

A

surgery - ductal occlusion

39
Q

what species are predisposed to VSD

A

cats, horses, cows, camelids

40
Q

restrictive vs nonrestrictive VSD

A

restrictive: very small opening between R and L ventricles

nonrestrictive: large opening between R and L ventricles

41
Q

murmurs in restrictive/nonrestrictive VSD

A

restrictive: very loud/harsh right sided murmur

nonrestrictive: none; blood flow is too slow due to the equilibrium of pressures

42
Q

what is the primary lesion in VSD

A

opening in between R and L ventricles causing blood to flow from LV to RV to pulmonary circulation back to LV

43
Q

what are the secondary lesions in VSD

A
  • eccentric hypertrophy of the LV from volume overload
  • pulmonary overcirculation
44
Q

what are signs of VSD on echo

A
  • color flow from LV to RV
  • high velocity flow if restrictive, low velocity if nonrestrictive
45
Q

what is the treatment for VSD

A

restrictive: none, usually subclinical

nonrestrictive: surgical closure if only involving muscular; or just treat CHF

46
Q

what species/breeds are predisposed to ASD

A

dogs (standard poodles), horses, cows, camelids

47
Q

murmur in ASD

A

left basilar systolic murmur

**NOT diastolic even though shunt is during diastole because it is slow flow - the fast flow occurs on the L side during systole as the LV pushes out the larger volume

48
Q

what is the primary lesion in ASD

A

opening between LA and RA

flows from LA to RA to RV then through the lungs back to the LA

LV never sees the increased load so even though its a L to R shunt, it causes R SIDED CHF

49
Q

what are the secondary lesions in ASD

A
  • eccentric hypertrophy of the RV from volume overload
  • pulmonary overcirculation
  • RA dilation
50
Q

what treatment is used for ASD

A

none - usually asymptomatic

51
Q

what defect causes a splintered QRS complex on ECG

A

tricuspid valve dysplasia

52
Q

what defect causes a tall QRS and wide P wave on ECG

A

PDA

53
Q

what defect causes a prominent Q wave on ECG

A

VSD

54
Q

what is eisenmenger syndrome and which defects can cause it

A

chronic, unresolved L to R shunting defects can lead to pulmonary hypertension, causing R sided pressure to exceed L sided pressure, leading to shunt reversal

55
Q

symptoms of eisenmenger syndrome

A
  1. cyanosis
    - PDA: differential cyanosis of the caudal half
    - VSD/ASD: generalized cyanosis
  2. polycythemia
    - deoxygenated blood reaching kidneys stimulates EPO production
56
Q

tetralogy of fallot

A

combination of 4 heart defects:
1. pulmonary stenosis
2. VSD
3. overriding aorta
4. RV concentric hypertrophy

57
Q

clinical signs of tetralogy of fallot

A

exercise intolerance, collapse, generalized cyanosis, R-CHF, polycythemia

58
Q

what is the normal ventricular outflow velocity (both R and L)

A

<2 mm/s

59
Q

what is the normal ventricular outflow pressure gradient

A

16 mmHg
(4x2^2 = 16)

60
Q

what is the pressure gradient during mild semilunar valve stenosis

A

25-50 mmHg

61
Q

what is the pressure gradient during moderate semilunar valve stenosis

A

50-80 mmHg

62
Q

what is the pressure gradient during severe semilunar valve stenosis

A

> 80 mmHg

VET 408: Cardio/Respiratory (38 decks)

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