CVS disease 1, 2, 3 Flashcards
dog regular HR
60-180 bpm
cat regular HR
120-240 bpm
most important congenital cardiac diseases
- aortic stenosis
- pulmonic stenosis
- patent ductus arteriosus
- ventricular septal defect
common aquired cardiac diseases in dogs
- myxomatous mitral valve disease (degenerative)
- dilated cardiomyopathy
- pericardial effusion
common aquired cardiac disease in cats
hypertrophic cardiomyopathy (myocardium disease)
typical presentation of heart disease in patients
- heart murmer or arrhythmia (cackle on auscultation)
- exercise intolerance, weakness, syncopal episodes
- sudden death
- reduced CO with heart failure
- pale MM, prolonged CRT
left sided congestive heart failure
- tachypnoea, dyspnoea
- pulmonary oedema
- cough?
right sided congestive heart failure symptoms
- dyspnoea
- distended abdomen
- ascites, pleural effusion
- positive hepatojugular reflux (press on liver and jugular vein distends)
cardiac disease physical exam findings
- loss of body condition (cardiac cachexia)
- loss of muscle mass with good appetite
- MM colour
- CRT
- distended jugular veins
- pulse deficits (heartbeat but no periipheral pulse)
- increased resp rate
- abnormal HR, rhythm
grading of heart murmers
- very quiet
- quiet, less loud than heart sounds
- obvious as heart sounds
- louder than heart sounds
- very loud with precordial thrill (palpation)
- very loud, thrill, audible without stethoscope on chest
congestive heart failure
blood is not pumped rapidly enough, pressure in atrium backs up into vein which causes fluid to accumulate upstream of the heart
diagnostic tests commonly used to investigate heart disease
blood tests
- haematology
- biochemistry
- cadiac biomarkers
bp
ECG
Echocardiography
Thoracic radiography
cardiac biomarker: cardiac troponin
marker for myocardial cell damage
cardiac biomarker: N-terminal pro-B-type natriuetic peptide
marker for myocardial stretch
ECG holter monitor
- worn 24hrs of the day
- investigates intermittent arrhythmias
- frequency and severity
- useful for syncope and antiarrhythmic therapy monitoring
thoracic radiograph indications
cough
tachypnoea
dyspnoe
- signs of lung pathology, heart failure
aortic subvalvular stenosis effect on heart
- left ventricular hypertrophy (increase in muscle mass)
- left congestive heart failure
pulmonary valvular stenosis effect on heart
-thickened valve or stuck together
- right ventricular hypertrophy
- right congestive heart failure
treatment of great vessel stenosis
- beta blocker
- balloon valvuloplasty (pulmonuc stenosis)
patent ductus arteriosus effect of heart
- normal fetal connection between pulmonary artery and aorta (should close after birth)
- if it doesn’t, blood flows from aorta to pulmonary artery (aortic pressure is higher)
- loud continuous murmer in left of heart
treatment of patent ductus arteriosus
- interventional closure (occluder disc)
- surgical ligation
- congestive heart failure therapy
ventricular septal defect effect on heart
- commonly located on upper septum below aortic valve
- smaller the defect, louder the murmer (garden hose)
- loudest murmer on right side of heart
- diagnosis= echocardiography
Myxomatous mitral valve disease
- idiopathic (hereditary)
- small breeds
- adult onset
- mitral, tricuspid valve
- diagnosis= echocardiography
myxomatous mitral valve disease effect on heart
- thickening of valve
- backflow of blood into atria
- left atria and ventricular dilation
- prolapse of valve into atria
myxomatous mitral valve clinical findings
- left sided apical systolic heart murmer
- slow progression with long asymptomatic period
- can progress to left sided congestive heart failure
dilated cardiomyopathy
- idiopathic (hereditary)
- large breed dogs
- adult onset
dilated cardiomyopathy clinical signs
- left apical systolic murmer (sometimes)
- disease of myocardium
- left ventricular dilation
- decreased systolic function
- arrhthmias
diagnosis= echocardiography
pericardial effusion
- large breed dogs
- many causes including idiopathic, neoplasia
diagnosis= echocardiography
pericardial effusion clinical signs
- fluid in the sac around the heart compromises filling (tamponade)
- right atria collapses first as lowest pressure
- decreased CO (heart can’t fill properly)
- right congestive heart failure
pericardial effusion treatment
- pericardiocentesis (drain fluid)
- use echocardiography
hypertrophic cardiomyopathy
- most common cardiac disease in cats
- genetic causes
- adult onset
- exclude other causes of hypertrophy (hyperthyroidism, systemic hypertension)
- increased myocardial thickness impairs filling in diastole
hypertrophic cardiomyopathy clinical signs
- right congestive heart failure
- pulmonary oedema, pleural effusion
- aortic thromboembolism
- sudden onset lameness, cold leg, cyanosis, pain
- can see platelets sticking together on echocardiogram (smoke look)
heart failure causes
- disease progression
- decompensation of previously stable heart failure
- development of impedance of cardiac filling
heart failure treatment
- furosemide (diuretic)
- decrease circulating volume
- minimise stress
- oxygen
- pimobendan (increases contractility in dogs)
- ACE inhibitor (vasodilator)
- spironolactone (weak diuretic)
heart failure monitoring
targets
- resp rate <40 breaths pm
- BP >100 mmHg
signs of improvement
- decreased resp rate and HR
- improved pulse quality and CRT
sinus bradycardia
causes:
- atrial standstill
- atrioventricular blocks (AVN not working properly)
- sick sinus syndrome
1st degree AV block
- slow conduction through AV node
- longer gap between P wave and QRS
2nd degree AV block
- some P waves are conducted but some arent
- more P waves as QRS complexes
- amount of P waves conducted is variable
3rd degree AV block
- no QRS complexes are conducted
- wide and bizarre QRS complexes
Atrial fibrilation
- no P wave
- very irregular rhythm
- HR: 210/min
ventricular arrhythmia
- originate from ventricular myocardium
- QRS complexes are wide and bizarre
- normal rhythm then really odd ones
ventricular premature complexes
QRS complex comes in earlier than you would expect
sinus arrhythmia
heart rate speeds up then slows down
ventricular tachycardia
- more than 3 fast beats in a row then slows down
- HR: 375/min
