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Cardiology (small) > Congenital heart disease (Yr 4) > Flashcards

Congenital heart disease (Yr 4) Flashcards

1
Q

what are the differentials for heart murmurs in puppies/kittens?

A

innocent “flow” murmur
anaemia (fleas…)
congenital heart disease

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2
Q

where does a patent ductus arteriosus run?

A

from descending aorta into pulmonary artery

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3
Q

how does the patent ductus arteriosus effect the heart?

A

causes left sided volume overload as blood flows from the aorta into the pulmonary artery and back into the left atrium

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4
Q

does the murmur associated with patent ductus arteriosus occur in systole or diastole?

A

continuous (pressure in aorta is always greater than the pulmonary artery)

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5
Q

what effect can volume overload of the left side of the heart due to patent ductus arteriosus have?

A

dilation of mitral valve annulus leading to mitral regurgitation
left sided heart failure

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6
Q

how does the femoral pulse of patent ductus arteriosus cases feel?

A

like tapping/waterhammer (continues blood moving into pulmonary circulation)

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7
Q

what is the most likely cause of a continuous murmur?

A

patent ductus arteriosus

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8
Q

what is the only congenital heart defect to have a sex predisposition?

A

patent ductus arteriosus (bitches more commonly effected)

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9
Q

what breeds is patent ductus arteriosus usually seen in?

A

German shepherds
collies
bichon frise, poodles…
cavalier King Charles spaniel

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10
Q

is patent ductus arteriosus more common in cats or dogs?

A

dogs (rare in cats)

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11
Q

how will a puppy with patent ductus arteriosus present?

A

initially asymptomatic (no stunting…)
murmur can be very localised initially

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12
Q

where is a patent ductus arteriosus murmur localised to?

A

left axilla

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13
Q

can patent ductus arteriosus be treated?

A

yes

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14
Q

what are the radiographic findings of patent ductus arteriosus?

A

left atrial/ventricle enlargement
“triple knuckle” on dorsoventral view

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15
Q

what causes the “triple knuckle” appearance of patent ductus arteriosus?

A

aortic, pulmonary artery and left atrial appendage

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16
Q

how will ECGs appear with patent ductus arteriosus?

A

really tall R waves - evidence of left ventricular enlargement
wide bifold P wave (P mitrale) - evidence of left atrial enlargement)

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17
Q

how can patent ductus arteriosus be treated?

A

surgery (thoracotomy and ligation of ductus)
catheterisation based occlusion of PDA (femoral artery/vein)

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18
Q

what happens to the left ventricle in cases of (sub)aortic stenosis?

A

pressure overload leading to concentric hypertrophy

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19
Q

what breeds is (sub)aortic stenosis seen in?

A

boxers
newfoundlands
golden retrievers
rottweillers
bull terriers

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20
Q

is (sub)aortic stenosis more common in dogs or cats?

A

dogs (uncommon with poor prognosis in cats)

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21
Q

why does (sub)aortic stenosis cause concentric hypertrophy?

A

there is increased afterload (pressure) on the left ventricle

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22
Q

why can concentric hypertrophy effect coronary circulation?

A

perfusion is compromised due to squashing of the coronary vessels and also the vessels not being able to keep up with the rate of hypertrophy

23
Q

why is myocardial ischaemia a big risk in (sub)aortic stenosis?

A

(sub)aortic stenosis causes concentric hypertrophy which can squash coronary vessels and the rate of hypertrophy can be too fast so the vessels are unable to keep up

24
Q

how would you describe a (sub)aortic stenosis murmur?

A

harsh mid/holosystolic murmur that radiates up the carotids on the right chest

25
Q

how can femoral pulses be effected by (sub)aortic stenosis?

A

with severe stenosis there can be weak pulses

26
Q

what two breeds have the highest predisposition to (sub)aortic stenosis?

A

boxers
newfoundlands

27
Q

what is the treatment for (sub)aortic stenosis?

A

no surgical treatment available

28
Q

what treatment should be avoided in (sub)aortic stenosis cases?

A

positive inotropes (pimobendan) or arteriodilators

29
Q

what effect does pulmonic stenosis have on the right ventricle?

A

concentric hypertrophy due to pressure overload

30
Q

what breeds is pulmonic stenosis mainly seen in?

A

cocker spaniels
cavalier King Charles spaniel
terriers
beagles
bull mastiff
boxer

31
Q

how do dogs with pulmonic stenosis present?

A

initial asymptomatic heart murmur
develop syncope and exercise intolerance

32
Q

how is the murmur associated with pulmonic stenosis described?

A

mid/holosystolic murmur cranially on the left heart base that radiates dorsally

33
Q

what are the pathophysiological consequences of pulmonic stenosis?

A

increased afterload of right ventricle causes right ventricular hypertrophy which can lead to myocardial ischamia

34
Q

what effect does very severe pulmonic stenosis have on the septum?

A

the pressure in the right ventricle can increase to more than the left changing the motion of the septum

35
Q

what radiographic changes are seen with pulmonic stenosis?

A

more sternal contact due to increased size of the right of the heart
bulging pulmonary artery (at 2 o’clock)

36
Q

how does pulmonic stenosis present on an ECG?

A

negative QRS in lead one (right axis deviation as there is greater muscle mass on right)

37
Q

how can pulmonic stenosis be treated?

A

surgical (dilate pulmonic annulus)
balloon valvuloplasty

38
Q

where does blood move from and too in ventricular septal defects?

A

from left to right ventricle

39
Q

what breeds is ventricular septal defect most common in?

A

cocker spaniel
west highland white terrier

40
Q

how does the grade of murmur in ventricular septal defects correlate to severity of disease?

A

inversely (the louder the murmur the less severe the disease is)

41
Q

why is the grade of murmur inversely correlated to the severity of disease in ventricular septal defects?

A

small defects maintain the pressure gradient between left and right ventricular leading to a very fast turbulent blood flow creating a loud murmur

42
Q

how would a murmur associated with ventricular septal defects be described?

A

systolic murmur with PMI on the right

43
Q

what is the pathophysiology associated with ventricular septal defects?

A

left to right shunt leading to volume overload of right ventricle and pulmonary over circulation causing a volume overload of the left atrium/ventricle which can cause left sided heart failure

44
Q

what are some possible sequelae to ventricular septal defects?

A

close with growth
aortic valve leaflets may prolapse and aortic regurgitation can develop
pulmonary hypertension can result in high right ventricular pressure leading to a shunt reversal (right to left)

45
Q

what breeds are predisposed to mitral dysplasia?

A

bull terriers
golden retrievers
great danes
German shepherds

46
Q

what breeds are predisposed to tricuspid dysplasia?

A

labradors

47
Q

what is the main consequence of mitral/tricuspid valve dysplasia?

A

regurgitation

48
Q

what are the pathophysiological features of mitral/tricuspid valve dysplasia?

A

regurgitation leading to volume overload and possible left/right sided heart failure (possible arrhythmias)

49
Q

which was do shunts occur in atrial septal defects?

A

left to right (not a massive pressure gradient)

50
Q

do murmurs occur in atrial septal defects?

A

not always - pressure gradient is low so little movement and turbulence is created

51
Q

what are the four defects in the tetralogy of fallot?

A

pulmonic stenosis
right ventricular hypertrophy
ventricular septal defect
dextroposed aorta

52
Q

what are some congenital cardiovascular abnormalities that can present without a murmur?

A

vascular ring anomalies (persistent right aortic arch)
peritoneopericardial diaphragmatic hernia

53
Q

what does a persistent right fourth aortic arch cause?

A

megaoesophagus (structure of the oesophagus)

Cardiology (small) (14 decks)

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