Diastolic dysfunction Flashcards
T/F: Pulmonary edema occurs with right heart diastolic dysfunction.
False! Left heart
What are some causes of primary diastolic dysfunction?
Hypertrophic obstructive cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
What are some secondary causes of diastolic dysfunction?
Pressure overload diseases
Pericardial diseases
What level of systolic BP is too high persistently at home? What is a better cut off for stressed out animals during an exam?
160 mmHg
180-200 mmHg
List some causes of secondary systemic hypertension?
Hyperaldosteronism Pheochromocytoma Acromegaly Medications Diabetes mellitus Hyper/hypothyroidism Hyperadrenocorticism Renal disease
What are the target organs for systemic hypertension
Brain, eyes, heart, kidney
T/F: If retinal changes are occuring, blood pressure is likely very high.
True
What retinal changes do you expect to see with systemic hypertension?
Vascular distension and tortuosity, retinal hemorrage
With concentric hypertrophy, do you expect fibrosis to be in the lumen or near the epicardium?
In the lumen, the cardiac vasculature comes from the outside, and blood vessels do not grow as the muscle hypertrophies, resulting in fibrosis
T/F: Systemic hypertension can be caused by primary heart disease.
False- should be normo to hypotensive with primary heart disease
T/F: On echocardiography, the walls of the ventricles should not touch in diastole or systole.
True!
What is the goal of treatment for systemic hypertension?
Decrease the blood pressure!
What classes of drugs can be used to decrease systemic vascular resistance?
ACE inhibitors
Alpha antagonist
Calcium channel blockers
What class of drugs can be used to decrease heart rate in cases of systemic hypertension?
Beta blockers
What is drug of choice for cats with renal disease to decrease blood pressure?
Amlodipine- CCB
What class of drugs are particularly good for cases of hypertension with proteinuria?
ACE inhibitors
- block peripheral vasoconstriction and efferent arteriolar vasoconstriction
T/F: Diuretics are first line drugs for systemic hypertension
False- especially with kidney disease, can make the problem worse
What species of cats is hypertrophic cardiomyopathy common in?
Maine coons, ragdolls
T/F: Primary HCM is a diagnosis of exclusion of all causes of secondary HCM
True
T/F: Cats can get pulmonary edema or pleural effusion with left sided CHF
True
T/F: Cats with arterial thromboemboli should be taken to surgery to remove the thrombus.
False, aside from them being poor surgical candidates, removing the clot can result in reperfusion injury.
What are 4 ECG changes seen with feline arterial thromboembolism induced hyperkalemia from reperfusion injury?
- tented t waves
- decreased p wave amplitude or absent
- increased PR interval
- wide QRS complexes
then… CARDIAC ARREST !
