Congenital Heart Disease and Pericardial Effusion Flashcards
What is Patent Ductus Arteriosus?
The ductus arteriosus that shunts blood from main pulmonary artery to descending aorta remains patent and causes chronic overcirculation of left heart (left to right shunting)
T/F: Males are more likely than females to get PDA?
False; females more likely
T/F: Small breeds are more likely to have PDA than large breeds?
True
On physical exam, where and when is the PDA murmur heard?
Left basilar, continuous
What is found on radiographs that is characteristic of PDA?
Ductal bump
In dogs with PDA, time to death is typically related to ___
Size of the shunt
What are three treatments for PDA?
Surgical ligation
Coil embolization
Canine ductal occluder
What is pulmonic stenosis and how does it occur?
Varying degrees of valve thickening, leaflet fusion, and hypoplasia of the valve annulus
Overproduction of valve elements or failure to convert embryonic valve primordia
On physical exam, where and when is a pulmonic stenosis murmur heard?
Left basilar, systolic
What are some signs one might see on a physical exam of a dog with pulmonic stenosis? (2)
Jugular pulsation
Ascites
What three things are found on an ECG of a pulmonic stenosis dog?
S waves leads I, II, III, aVF
MEA shifted to right
RV enlargement pattern
What are two treatments for pulmonic stenosis?
Balloon valvuloplasty
Medical management
What is the most common congenital cardiac malformation of large breed dogs?
Subaortic stenosis
What is subaortic stenosis?
Fixed ridge or ring of tissue in the LVOT, just below the aortic valve
What are three sequelae of subaortic stenosis?
Increased ventricular systolic pressure
Concentric hypertrophy
Often endocarditis
T/F: Subaortic stenosis is most likely inherited via autosomal recessive mode of transmission
False; autosomal dominant
Where and when is a subaortic stenosis murmur located?
Left basilar, systolic
What are the pulses like in subaortic stenosis?
Weak, parvus et tardus (to and fro)
How can one identify subaortic stenosis on and ECG? (2)
Tall R waves (LV enlargement)
Raised/depressed ST segments
What are three treatment options for subaortic stenosis?
Balloon valvuloplasty
Medical management
Exercise restriction
Pulmonic stenosis is more commonly seen in ___ (large/small) breeds, while subaortic stenosis is more commonly seen in ___ (large/small) breeds
Small
Large
What are the four components in tetralogy of Fallot?
Overriding aorta
Pulmonary stenosis
Ventricular septal defect
Right ventricular hypertrophy
What are three consequences of tetralogy of Fallot?
Shunting of unoxygenated blood into systemic circulation
Cyanosis
Polycythemia
What are the three types of septal defects?
Atrial septal defects
Ventricular septal defects
Atrioventricular septal defects
What is Eisenmenger’s syndrome?
R - L shunting
What is seen on an ECG when tricuspid valve dysplasia is present?
Splintered QRS waves
What are three options for treatment of valvular defects?
Surgery - typically not available
Beta blockers for LVOT
CHF management if present
What are the major causes of pericardial effusion in dogs and cats?
Dogs - Idiopathic Neoplasia Fungal FB Coagulopathy LA rupture Uremia
Cats -
CHF
Neoplasia
FIP
What is cardiac tamponade?
Cardiac compression arising from intrapericardial pressure
How do clinical signs of cardiac tamponade develop?
Pressure causes reduced filling and hypotension
Eventually compensation for low CO leads to R CHF or biventricular CHF
How is pericardial disease diagnosed?
Thoracic rads - globoid heart, dorsal deviation of the trachea CBC, chem Fungal titers Coag panel Troponin I
How is pericardial disease staged?
Acute
Surgical
Medical
How is pericardial disease managed in dogs? Cats?
Acute - pericardiocentesis, fluid therapy
Surgical - Pericardiectomy
Medical - Chemo, radiation, steroids (nothing definitive)
What is pulsus paradoxicus?
Variation in cardiac filling over time
What is a chemodectoma?
A heart base mass
