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Module 15- Cardiorespiratory And Haemopoietic > Congenital mumurs in puppies and kittens > Flashcards

Congenital mumurs in puppies and kittens Flashcards

1
Q

Define pathological (cardiac) murmurs

A

Incompetent or stenotic valve
Flow through shunts

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2
Q

Define physiological (functional) murmurs

A

Changes in blood viscosity or velocity
E.g. Anemia/Hypoproteinaemia/Atheletes

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3
Q

Define Innocent (Flow) murmurs

A

Soft (Maximum grade 1-2), systolic, short, variable, localised

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4
Q

Outline murmur grade classification

A

Grade 1: difficult to hear
Grade 2: quieter than heart sounds
Grade 3: equal to heart sounds
Grade 4: louder than heart sounds
Grade 5: palpable thrill
Grade 6: thrill and can hear with stethoscope off the chest wall

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5
Q

State 4 causes of murmurs in puppies and kittens

A

Innocent (“flow”) murmur
Systemic disease e.g. anaemia
Acquired disease - RARE
Congenital anatomical defect

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6
Q

When do Innocent murmurs go away in puppies and kittens

A

Usually gone by 16 to 20 weeks of age

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7
Q

Top three most common congenital heart diseases in dogs

A

Aortic stenosis
Patent ductus arteriosus
Pulmonary stenosis

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8
Q

Top three most common congenital heart diseases in cats

A

Ventricular septal defect
Mitral valve dysplasia
Tricuspid valve dysplasia

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9
Q

Aortic stenosis

A

Narrowing of the exit of the left ventricle of the heart

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10
Q

Patent ductus arteriosus

A

Oxygenated blood from the left heart flows back to the lungs through the aorta, which has a higher blood pressure, to the pulmonary artery, which has a lower blood pressure

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11
Q

Pulmonary stenosis

A

Obstruction of flow from the right ventricle of the heart to the pulmonary artery

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12
Q

Ventricular septal defect

A

Defect in the ventricular septum, the wall dividing the left and right ventricles of the heart.

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13
Q

Majority of congenital heart murmurs in dogs and cats are? Systolic OR diastolic. What congenital disease is the exception

A

Systolic
Patent ductus arteriosus- Continuous

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14
Q

Murmurs when auscultating the left heart base may be due to?

A

Patent ductus arteriosus (continuous)
Aortic stenosis (systolic)
Pulmonary stenosis (systolic)
Innocent/functional murmurs (systolic)

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15
Q

What murmurs can you hear when you auscultate the Left heart apex

A

Mitral valve dysplasia (systolic)

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16
Q

Hearing murmurs when auscultating the Right side of thorax could be a cause of?

A

Tricuspid valve dysplasia (systolic)
Ventricular septal defect (systolic)
Tetralogy of Fallot (systolic)

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17
Q

What can one expect to see on a thoracic radiograph of a patient with patent ductus ateriosus

A

Left sided enlargement, vascular congestion, aorta and pulmonary artery enlargement

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18
Q

What can one expect to see on a thoracic radiograph of a patient with Pulmonic stenosis

A

Right sided enlargement, decreased vascularity, pulmonary artery enlargement

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19
Q

Dog breeds predisposed to Aortic stenosis

A

Boxer
Golden retriever
German shepherd
Rottweiler
Newfoundland

20
Q

Clinical history of aortic stenosis

A

Asymptomatic
Exercise intolerance
Syncope
Sudden death
Left sided congestive heart failure (dyspnoea, tachypnoea, cough)

21
Q

Clinical examination of aortic stenosis

A

Weak pulse
Harsh systolic murmur left heart base
+/- left sided CHF

22
Q

Treatment for mild cases of aortic stenosis

A

no treatment, good prognosis

23
Q

Treatment for severe cases of aortic stenosis

A

beta-blockers, calcium channel blockers (diltiazem) will reduce HR, reduce outflow gradient, reduce risk of arrhythmias and may improve quality of life but no proven impact on survival

24
Q

Pathophysiology of aortic stenosis

A
  1. Aortic valvular or sub valvular narrowing
  2. Pressure overload of left ventricle
  3. Decreased CO resulting in forward failure resulting in exercise intolerance
  4. Concentric hypertrophy of left ventricle resulting in arrhythmias/diastolic dysfunction/LSCHF
25
Q

Explain why patent ductos arteriosus can cause Caudal cynanosis and hindlimb weakness

A
  1. Excessive circulation of blood through the lungs
  2. Irreversible changes to lung
  3. Pulmonary hypertension and reverse shunting
26
Q

Explain why patent ductos ateriosus can cause LSCHF

A
  1. Blood shunts from artery to pulmonary atery
  2. Excessive circulation of blood through lungs
  3. Volume overload of left ventricle and atrium
27
Q

Dog breeds predisposed to PDA

A

German Shepherd
Border Collie
Springer Spaniel
Poodle
Chihuahua

28
Q

Clinical examination of a dog with PDA

A

Dynamic pulse ‘water hammer pulse’
Continuous murmur left heart base ‘machinery murmur’
+/- signs of left sided congestive heart failure

29
Q

Clinical findings of patients with Reverse PDA

A

Weakness hindquarters
Caudal cyanosis
+/- murmur

30
Q

Diagnosis for reverse PDA

A

Echocardiography- May require contrast echo to diagnose with simultaneous imaging of aorta
Pulmonary hypertension

31
Q

Treatment for reverse PDA

A

Non-surgical
Develop right heart failure if occluded
Sildenafil for pulmonary hypertension
Phlebotomy if develop polycythaemia

32
Q

Dog breeds predisposed to Pulmonic Stenosis

A

Boxer
Cocker spaniel
Beagle
Bull dog
Westie

33
Q

T/F Pulmonic Stenosis is common in cats

A

False!

34
Q

History of dog with Pulmonic stenosis

A

Asymptomatic
Exercise intolerance
Syncope
Sudden death
Right sided CHF (ascites, dyspnoea)

35
Q

Clinical examination of dog with pulmonic stenosis

A

Weak pulse
Harsh systolic murmur left heart base
+/-ascites/pleural effusion

36
Q

Treatment for severe pulmonic stenosis

A

Beta-blockers
Balloon valvuloplasty – works best if fused valves
Stent

37
Q

Pathophysiology of Ventricular septal defect

A
  1. LARGE ventricular septal defect
  2. Shunting from left to right
  3. Overcirculation of lungs
  4. Left sided CHF OR Pulmonary hypertension causing RCHF
38
Q

Dog Breeds predisposed Ventricular Septal Defect:

A

Bulldog
Keeshound
Springer Spaniel

39
Q

T/F Ventricular septal defect is the most common congenital cardiac defect in cats

A

True!

40
Q

History of Ventricular septal defect

A

Asymptomatic
Exercise intolerance
Left sided congestive heart failure (dyspnoea, tachypnoea, cough)

41
Q

Clinical examination of Ventricular septal defect

A

Strong pulse
Systolic murmur right ventral thorax
+/- left sided CHF

42
Q

What is the most common cyanotic congenital heart disease

A

Tetralogy of fallot

43
Q

Tetralogy of fallot

A
  1. Ventricular septal defect.
  2. Pulmonary stenosis.
  3. The aortic valve, which opens to the aorta, is enlarged and seems to open from both ventricles. In this defect, the aortic valve sits directly on top of the ventricular septal defect.
  4. Right ventricular hypertrophy
44
Q

Physical examination of patient with tetralogy of fallot

A

+/- murmur depends on presence of polycythaemia
+/- cyanosis
+/- dyspnoea

45
Q

T/F Tricuspid dysplasia cases and animals with small VSDs cannot have a normal life span

A

False

Module 15- Cardiorespiratory And Haemopoietic (21 decks)

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