Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SAM 1 > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

what are the three most common congenital heart diseases in dogs?

A

patent ductus arteriosus, subaortic stenosis, and pulmonic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the three most common congenital heart diseases in cats?

A

ventricular septal defect, tricuspid valve dysplasia, mitral valve dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what sort of shunt is present in PDA?

A

L-R shunt UNLESS reversed then R-L shunt occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the cause of a PDA?

A

ductus arteriosus (ligamentum arteriosum in adults) remains patent after birth

=communication between PA and aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what type of hypertrophy do you see in PDA?

A

eccentric (volume overload to left side of heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

bichons, chihauhaus, poodles, GSDs, corgis, and shetland sheepdogs are all breeds predisposed to what congenital heart dz?

A

PDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what type of heart murmur does a patient with PDA have?

A

continuous with PMI at left base, usually high grade (IV-VI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are most femoral pulses like in patients with PDA?

A

strong or “bounding” (lower diastolic pressure so pulse pressure difference larger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are two ways you can cure PDA?

A

surgical ligation (thoracotomy) or transcatheter occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what test can you do to look for PDA in which you inject a radiopaque dye to highlight it?

A

angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

reversed PDA occurs secondary to what?

A

pulmonary hypertension (PA pressure > Ao pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T/F: PDA is often symptomatic whereas reversed PDA is often asymptomatic

A

FALSE, PDA often asymptomatic unless develops develops CHF). reversed PDA is often symptomatic (hypoxemia, polycythemia, differential cyanosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what heart sounds might you hear with reversed PDA?

A

split S2, +/- murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you manage a patient with reversed PDA?

A

exercise restriction, phlebotomy, +/- bone marrow suppression drugs (hydroxyurea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

fibrous or fibrocartilaginous subvalvular lesion creating a nodule, ridge/ring, or “tunnel” leading to obstruction of blood from LV to aorta is describing what type of congenital heart disease?

A

SAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what type of hypertrophy do you see with SAS?

A

concentric (pressure overload to left side)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what might you see on a radiograph of a patient with SAS?

A

prominent ascending aorta and L-sided cardiomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: SAS is most often seen in small or toy breed dogs

A

FALSE, usually LBD (g. retriever, newfoundland, rottweiler, GSD, boxer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dogs with SAS tend to be asymptomatic. if moderate-severe and symptomatic, what signs might you see?

A

exercise intolerance, syncope, L-CHF signs, sudden death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what murmur is seen in patients with SAS?

A

left basilar systolic (often holosystolic) murmur, any grade

aortic regurg?? + diastolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

a continuous wave doppler in an echo of a dog with SAS is helpful for what?

A

measures velocity of blood ejected in systole from LV so estimates pressure gradient which determines severity

mild: <40 mm Hg
mod: 41-80 mm Hg
severe: >80 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the main cause of sudden death in dogs with SAS?

A

lethal ventricular arrhythmias

may see R-on-T (ventricle depolarizes before done repolarizing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

there is no curative treatment of SAS but what drug might you consider to improve MST?

A

atenolol (beta blocker)

decreases myocardial oxygen demand, improves myocardial perfusion, may reduce ventricular arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why might you give a patient with SAS antibiotics?

A

because SAS is a risk factor for endocarditis, high velocity blood flow damages valve and walls increasing its chances for bacteria to take advantage (i.e. diastolic murmur and aortic regurgitation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

is valvular pulmonic stenosis more common in dogs or cats?

A

dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

in pulmonic stenosis there is usually markedly thickened cusps due to dysplasia +/- commissural fusion or annular hypoplasia

A

TRUE, limits the opening for blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what type of hypertrophy results from PS?

A

concentric (pressure overload)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what types of breeds more commonly have PS?

A

terriers, english bulldogs, beagles, samoyeds, chihauhaus, labs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

T/F: due to the high pressure buildup from the stenosis, dogs who have PS are often symptomatic

A

FALSE, usually asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

would you expect to see L-CHF or R-CHF in a dog with PS?

A

R-CHF (issue is getting blood from the right ventricle to the pulmonary artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what type of murmur would you expect in a patient with PS?

A

left basilar systolic (often holosystolic) murmur, any grade

32
Q

T/F: the end of the right ventricle is on the left side of the chest

A

TRUE, crescent shape (think PAM for auscultation on the left side)

33
Q

what anomoly can bulldogs or boxers have that might cause you to reconsider balloon vulvuloplasty for PS?

A

anomalous right coronary artery (artery wraps around the pulmonary trunk, BV can cause to rupture)

34
Q

when should you consider balloon valvuloplasty in a patient with PS?

A

consider if PG 50-80 mm Hg, indicated if > 80 mm Hg

35
Q

a balloon valvuloplasty in a patient with PS is considered successful if the reduction of PG is what?

A

> 50%

36
Q

what drug may help to reduce arrhythmias in patients with PS?

A

atenolol

37
Q

where are ventricular septal defects usually located?

A

high in the perimembranous region

38
Q

what type of shunt do you see in a VSD?

A

L > R shunt

39
Q

what type of hypertrophy do you see in a VSD?

A

eccentric (volume overload to left side)

40
Q

concurrent congenital defects are common in dogs with VSD, what one is MOST common?

A

pulmonic stenosis

41
Q

what happens if severe pulmonary hypertension develops or a severe PS is present in a dog with VSD?

A

shunt will reverse!! (pressure becomes higher in pulmonary artery than left ventricle and blood begins to flow from R > L instead)

42
Q

are VSDs more common in cats or dogs?

A

CATS, dogs (english springer spaniel, west highland white terrier, lakeland terrier, basset hound, english bulldog)

43
Q

T/F: VSDs are often asymptomatic, but if large can result in L- or biventricular CHF

A

TRUE

44
Q

in a patient with VSD, what type of murmur do they have and where is it usually loudest?

A

systolic, right parasternal region

smaller the defect, the louder the murmur

45
Q

what treatments might you consider for a patient with VSD?

A

mod-large: cardioprotective drugs
interventional (catheter-based) options > occlude/plug defect

*large require PA banding or open-heart surgery (increase pressure on right side to decrease L > R flow)

46
Q

what part of the valve is usually affected by tricuspid and mitral valve dysplasia?

A

any part! thickened/elongated/shortened leaflets, shortened/absent chordae tendinae, abnormal papillary mm.

47
Q

what can occur as a result of TVD?

A

TV regurgitation > stenosis

48
Q

what type of hypertrophy do you see with TVD?

A

eccentric (volume overload to right side)

49
Q

T/F: the foramen ovale may remain patent due to high right atrial pressure in TVD

A

TRUE

50
Q

are TVD more common in cats or dogs?

A

CATS, dogs (labs, boxers, irish setters, GSD)

51
Q

what type of CHF do you see in a patient with TVD?

A

right-sided CHF

52
Q

what type of murmur would you expect in a patient with TVD?

A

right apical systolic murmur, can be low grade even with severe disease

stenosis? may hear diastolic murmur

53
Q

T/F: when tricuspid regurgitation is severe the RV is usually small

A

FALSE, left ventricle

54
Q

what sign on an ECG could you see that might lead you to believe you have a TVD?

A

“splintered” QRS complexes

55
Q

a patient who has TVD has stenosis as well, grossly what would you expect the heart to look like?

A

RA is dilated, RV is small

56
Q

what would you prescribe patients with moderate or severe TVD or MVD?

A

cardioprotective drugs

57
Q

what would you recommend for a patient with severe TVD or MVD and CHF?

A

surgical valve replacement, balloon valvuloplasty

shortened lifespan!

58
Q

T/F: valve dysplasias will present with systolic murmurs when stenosis is present and diastolic murmurs when regurgitation is present

A

FALSE, opposite

regurgitation > systolic
stenosis > diastolic

59
Q

when stenosis is present in MVD the LA is small and the LV is dilated

A

FALSE, the LA is dilated and the LV is small

60
Q

your patient with MVD has a LV outflow tract obstruction, what drug therapy might be helpful?

A

beta blocker therapy

61
Q

complex congenital defects involving the AV septum, atrial septum, and ventricular septum describe what congenital heart dz?

A

atrioventricular septal defects

62
Q

are AVSDs more common in cats or dogs?

A

cats

asymptomatic +/- tachypnea/dyspnea or syncope

63
Q

where is the PMI of the murmur in a cat with AVSD?

A

left or right parasternal, diastolic, or systolic

64
Q

T/F: a patient with an AVSD can have CHF or sudden death as a complication

A

TRUE, no surgical/interventional therapy available

65
Q

what are the four heart defects make up the tetralogy of fallot (ToF)?

A
  1. pulmonic stenosis
  2. secondary concentric hypertrophy of RV
  3. overriding aorta
  4. ventricular septal defect
66
Q

hypoxemia and polycythemia are a result of what in tetralogy of fallot?

A

PS > high pressure in RV > R to L shunt (because of ventricular septal defect)

67
Q

what is the most common cause of cyanotic heart disease in cats and dogs?

A

tetralogy of fallot (ToF)

68
Q

what palliative surgical procedure can be done for ToF?

A

systemic-to-pulmonary anastomosis (modified Blalock-Taussig shunt) > improves pulmonary blood flow and reduces hypoxemia

69
Q

what is the definitive treatment for ToF?

A

open-heart repair of VSD and PS

70
Q

why is complete balloon valvuloplasty not performed in a patient with ToF and only partial done?

A

it would lead to a large L-to-R shunt

71
Q

non-selective beta blocker (propanolol) therapy, exercise restriction, phlebotomy (PCV > 65%) and +/- hydroxyurea are all ways to medically manage what congenital defect?

A

tetralogy of fallot

72
Q

systolic, low grade (I-III/VI) murmur with the PMI over the aortic/pulmonary valve (left heart base) that disappears by 6 months of age are all criteria to be considered what type of murmur?

A

innocent heart murmurs

73
Q

vascular ring anomoly characterized by persistence of the right fourth aortic arch during fetal development describes what congenital defect?

A

persistent right aortic arch (PRAA)

74
Q

what congenital defect causes regurgitation in puppies and kittens because the esophagus is entrapped in the “ring”?

A

PRAA

75
Q

blood flow from the LA > RA, often low grade murmur, and split S2 are all characteristics of what congenital defect?

A

atrial septal defect

76
Q

what might a large ASD result in?

A

severe pulmonary hypertension > shunt reversal

SAM 1 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions