Congenital heart disease

Question 1

What is congenital heart disease

Answer 1

malformations of the heart and great vessels that occur due to altered or arrested embryonic development
many animals are asymptomatic when first examined

Question 2

Describe an innocent murmur

Answer 2

low grade 1-2
murmur loudest= left heart base
varying intensity with heart rate
usually resolve by 6 months (exception some large breeds)

Question 3

What is the only way you can assess the nature and severity of a murmur

Answer 3

full doppler echocardiogram

Question 4

If you hear a <grade 2 murmur in a puppy what to do

Answer 4

could be innocent
re-assess at 3 and 6 months
need to warn owners

Question 5

if you hear a loud (grade 3+) murmur in a puppy what should you do

Answer 5

more likely to be a congenital anomaly
more likely to want to scan these

Question 6

List the 4 most common types of congenital heart disease

Answer 6

Aortic stenosis
patent ductus arteriosus
pulmonic stenosis
ventricular septal defect

Question 7

Describe Aortic stenosis

Answer 7

= narrowing of the aorta
3 types

Question 8

what is the most common type of aortic stenosis

Answer 8

sub-aortic stenosis

Question 9

describe sub-aortic stenosis

Answer 9

Sub valvular narrowing caused by a fibrous or fibromuscular ring
Can increase in severity as dog matures reaching maximum severity at 1-2 years of age
Exercise / excitement can cause an increase in the intensity of the murmur

Question 10

What breed are you most likely to see sub-aortic stenosis in

Answer 10

Boxers
Newfoundlands
Golden Retrievers

Question 11

Describe the sound caused by aortic stenosis

Answer 11

harsh systolic ejection murmur
murmur loudest= aortic valve

Question 12

describe the historical and clinical findings you would see in a case of aortic stenosis

Answer 12

historical- vary from none to syncope (fainting)
Lethargy, exertional weakness, syncope, sudden death

Question 13

How many types of pulmonary stenosis are there and which is the most common

Answer 13

5 types
valvular pulmonic stenosis

Question 14

what breed do you tend to see pulmonic stenosis in

Answer 14

usually smaller breed dogs
terriers, bulldogs

Question 15

how to pulmonic stenosis cases present

Answer 15

many asymptomatic
clinical signs depend on severity
right sided heart failure, syncope, exercise intolerance

Question 16

Describe the murmur you would hear with a pulmonic stenosis

Answer 16

High frequency systolic ejection murmur
prominent right apical beat
murmur loudest= left heart base
prominent jugular pulses

Question 17

Describe a patent ductus arteriosus

Answer 17

blood shunting from aorta into pulmonary artery
continuous murmur
Best heart over left heart base but very cranial and dorsal (in axilla)
Very important to detect as potentially curable

Question 18

What happens if you don’t fix a patent ductus arteriosus

Answer 18

After 12 months many dogs will progress into left sided congestive heart failure adn show typical clinical signs

Question 19

How do you treat PDA

Answer 19

surgical- ligate it
Occluder- placed through cannula in femoral artery

Question 20

Where do ventricular septal defects occur

Answer 20

high in the membranous part of the septum just below the aortic valve and under the tricuspid leaflet

Question 21

Describe a how a ventricular septal defect sounds

Answer 21

small defects (which are clinically unimportant) cause a very loud murmur
large defects- very quiet
systolic murmur loudest over cranial right sternal border