Congenital Heart Disease Flashcards
What are the top 3 congenital heart diseases in dogs?
- PDA (patent ductus arteriosus)
- SA (subaortic stenosis)
- PS (pulmonic valve stenosis)
What are the top 3 congenital heart diseases in cats?
- VSD (ventricular septal defect)
- PDA (patent ductus arteriosus)
- TVD (tricuspid valve dysplasia)
What are the 2 types of patent ductus arteriosus (PDA)? Which is most common?
Left to Right shunt = most common
Right to Left shunt = very small minority
How is L-R and R-L PDA differentiated on physical Exam?
L-R: loud continuous murmur, palpable thrill
- see aortic bulge on CXR, L sided cardiomegaly
R-L: no murmur, or a soft systolic murmur, accentuated split 2nd sound
- see aortic bulge on CXR, R sided cardiomegaly
- differential cyanosis (made only be visible after exercise)
What are some clinical signs associated with PDA?
most PDA = asymptomatic at diagnosis
R-L
- exercise intolerance
- differential cyanosis
- dyspnea, shortness of breath, hyperpnea
- hind end weakness
- seizure (rare)
How is PDA treated?
L-R:
- surgery
R-L:
- NO surgery – will die from R sided heart failure
- lifestyle modification: reduce activity burden, periodic phlebotomy, prevent dehydration,. sildenafil
Which feline breed has shown predisposition to ventricular septal defect?
Main Coon
What are some clinical signs associated with ventricular septal defect?
R sided harsh, holosystolic murmur
What’s the treatment for ventricular septal defect?
surgery
Which gender is more affected in dogs with PDA?
female
Which breeds are predisposed to AV valve disease?
Bull terrier - mitral valve stenosis
Large breeds, male - tricuspid valve dysplasia (ex. Lab)
What’s the hallmark of valvular insufficiency?
holosystolic murmur, best heard over the affected area
What can be noted on ECG for TVD?
Splintered QRS = distinct and common finding
- atrial arrhythmia, esp atrial fibrillation (animals with valvular degeneration are predisposed to atrial fibrillation) –> can have a sudden decline in clinical signs
What are some CXR signs for valvular stenosis?
markedly dilated atrium without enlargement of the ipsilateral ventricle = high suspicion for valvular stenosis
What are some clinical signs associated with valvular insufficiency?
generally asymptomatic at rest
- exertional induced fatigue
- CHF
- hemoptysis with mitral valve
- pulmonary hypertension
What’s the treatment for valvular insufficiency?
Surgery
medical therapy for CHF
What are the clinical findings for dogs with pulmonic stenosis?
- usually nothing in the first year of life
- murmur can be detected – left, heart base, systolic ejection
What’s a common congenital heart anomaly in large breed dogs?
Subvalvular aortic stenosis
Which breeds commonly have subvalvular aortic stenosis? which one has valvular aortic stenosis?
SAS:
- Newfoundland, Boxers, Rotties, German Shepherds, Gold Retrievers
Valvular = bull terriers
What are the clinical signs associated with SAS?
Majority of the dogs are asymptomatic, but it’s a serious condition in severely affected dogs –> risk of sudden death
- murmur may become increasingly more prominent as patient ages
- exercise intolerance, syncope, left sided CHF
- smaller than its health littermates
What ECG features can be seen with SAS?
depressed ST segments
How is SAS treated?
mild cases: nothing, maybe prophylactic antibiotics with suspectedly bacteremia
- balloon dilation – good for short term, long term probably no different than atenolol
- avoid vigorous exercise
- beta blockers (atenolol) for dogs with syncope
What are the defining anatomic features of tetralogy of Fallot?
- right ventricular outflow obstruction
- secondary right ventricular hypertrophy
- ventricular septal defect
- rightward positioned aorta
Which breeds are predisposed to tetralogy of Fallot?
Keeshond, English bulldogs; some families of other breeds
What are the clinical signs of tetralogy of Fallot?
- cyanotic heart disease, secondary erythrocytosis
- exercise intolerance
- small or normal heart size, rounding of the right ventricle
- main pulmonary artery is not enlarged
How is tetralogy of Fallot treated?
- can be tolerated for years
- sever exercise intolerance
- sudden death possible
- CHF not usual
- surgical or medical approach
- surgery can create a L-R shunt distal to the cyanotic defect - stenosis should not be relieved unless the ventricular septal defect is addressed to avoid shunting of L to R, and L sided CHF
