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SEM 5: SAM 1 > Endocarditis, Myocarditis, Pericardial Disorders, and Cardiac Neoplasia > Flashcards

Endocarditis, Myocarditis, Pericardial Disorders, and Cardiac Neoplasia Flashcards

1
Q

True or False: DMVD has been shown to be a risk factor for infectious endocarditis

A

FALSE

subaortic stenosis is a risk factor for endocarditis

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2
Q

What is the most common presenting complaint for a patient with infectious endocarditis?

A

LAMENESS

(+ fever)

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3
Q

What are the non-cardiac complications that occur with infectious endocarditis?

A
  1. Polyarthritis
  2. Glomerulonephritis
  3. Thromboembolic disease (due to loss of AT3)
  4. CHF + arrhythmias
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4
Q

What type of murmur would you expect to hear in a patient with endocarditis and vegetative lesions on the mitral valve?

A

Left apical systolic murmur (due to mitral regurg)

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5
Q

What type of murmur would you expect to hear in a patient with infectious endocarditis and vegetative lesions on the aortic valve?

A

Left basilar diastolic murmur (due to aorta regurg) + bounding femoral pulses

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6
Q

Infectious endocarditis that has progressed to CHF is usually _____ sided

A

left

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7
Q

List the most common causative agents associated with infectious endocarditis

A
  1. Staph intermedius
  2. Staph aureus
  3. Strep canis
  4. E. coli
  5. Pseudomonas
  6. Bartonella
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8
Q

What is the antibiotic therapy protocol for endocarditis?

A

Long-term bactericidal Abx

  • Beta lactam + Enrofloxacin
  • Given IV for 1-2 weeks, then PO for 6-8 weeks

(+ CHF meds if present)

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9
Q

True or False: Fluid therapy, such as SQ fluids, should be given to a patient in CHF

A

FALSE FALSE FALSE contraindicated

(already have volume overload/too much preload to the heart, this would make it worse)

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10
Q

What is the prognosis of a pet with infectious endocarditis?

A
  • Permanent valve damage (regurg) despite resolution
  • Grave prognosis with aortic IE (days)
  • Better outcome if mitral valve IE (> 1 yr)
  • Worse prognosis if: refractory CHF, thromboembolism, or renal failure
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11
Q

An owner brings in a golden retriever with infectious endocarditis and is told by the vet that the prognosis is guarded, the pet may live just days longer. Which valve is likely affected?

A

Aortic valve - grave prognosis

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12
Q

Myocarditis can result in ________ dysfunction and heart failure

A

systolic

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13
Q

________ is a cardiac biomarker that is used in the diagnosis of myocarditis

A

Cardiac troponin I

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14
Q

If you’re a practicing veterinarian in the southern US, ____________ should always be on your list of differentials when suspect of myocarditis

A

Chagas disease - Trypanosoma cruzi

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15
Q

What is the most common cause of acquired pericardial effusion in dogs?

A. Neoplasia
B. Idiopathic
C. Infectious
D. CHF

A

A. Neoplasia

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16
Q

What is the most common cause of acquired pericardial effusion in cats?

A. Neoplasia
B. Idiopathic
C. Infectious
D. CHF

A

D. CHF

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17
Q

How can pericardial effusion lead to cardiac tamponade?

A

When IPP exceeds ICP

Heart can’t expand, diastolic filling decreases (preload decreases), then SV decreases and then CO

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18
Q

Age, breed, and sex predilection associated with pericardial effusion in dogs?

A
  • Middle to older
  • Medium to large breeds (GSD, Goldens, Labs, brachycephalic breeds)
  • Males > females
19
Q

How do dogs with acute pericardial effusion present?

A

On an ER bases for collapse or weakness, +/- acute vomiting

20
Q

How do dogs with chronic pericardial effusion typically present?

A
  • Vague CS
  • Lethargic, exercise intolerance, ABD distension
  • Coughing, panting, tachypnea/dyspnea
21
Q

Pulsus paradoxus is when the arterial pulse pressure decreases during inspiration. This occurs with what heart condition?

A

Pericardial effusion

22
Q

What would you expect to hear during your cardiac and respiratory portion of a PE on a dog with pericardial effusion?

A
  • Muffled heart sounds if large amount of pericardial effusion
  • Lung sounds decreased if pleural effusion
  • Jug distension
  • Tachypnea/Dyspnea
  • If cardiac tamponade: low BP
23
Q

Explain the fluid you would expect to see after performing a pericardiocentesis on a dog with pericardial effusion?

A

Sanguineous (hemorrhagic)

24
Q

CHF due to pericardial effusion is usually _______ sided

A

Right

25
Q

What valves are most commonly affected by infectious endocarditis?

A

Mitral and aortic valves (L side of heart)

26
Q

What are the risk factors for developing infectious endocarditis?

A
  1. Bacteremia due to any cause (UTI, pneumonia, pyoderma, infected wound, etc)
  2. Subaortic stenosis
  3. Immunosupression
  4. Dental procedure
27
Q

DDx for a dog presenting with a heart murmur and fever? (cardiac causes)

A

Infectious endocarditis or myocarditis

(NO OTHER HEART DZ CAUSES FEVER)

28
Q

How can infectious endocarditis lead to thromboembolic disease?

A

Glomerulonephritis causes AT3 to be lost with Albumin

Loss of AT3 causes hypercoaguable state and thrombus formation

29
Q

_________ may develop after a respiratory or GI infection, vaccination, surgery, trauma, or drug exposure

A. Endocarditis
B. Myocarditis
C. Pericardial effusion

A

B. Myocarditis

30
Q

How does Chagas disease typically present in a dog?

A
  • Fever
  • Enlarged LN
  • Arrhythmias
  • Myocardial dysfunction
  • CHF
31
Q

Most common locations for hermangiosarcoma?

A
  • Right atrium / Right auricle
  • Spleen
  • Lungs
32
Q

What is the treatment protocol for a patient with a heart base tumor?

A

(Chemodectoma)

  • Pericardiectomy
33
Q

List all the heart conditions resulting in sudden death in dogs and cats

A

Cats > dogs
1. AVSD
2. HCM
3. RCM

Dogs > cats
4. DCM
5. ARVC
6. Subaortic stenosis

34
Q

Which of the following could result in a globoid cardiac silhouette on thoracic radiographs?

A. Myocarditis
B. Endocarditis
C. Pericardial effusion

A

C. Pericardial effusion

35
Q

Which drug is contraindicated in a patient with cardiac tamponade?

A

Diuretics (Furosemide)

  • Already low preload, CO and SV
  • Dont won’t to loose more fluid vol.. will make it worse
36
Q

What is the prognosis for a patient with hermangiosarcoma on the right auricle resulting in pericardial effusion and cardiac tamponade?

A

Pericardiocentesis + If just on auricle - can be surgically resected

Chemo + surgery gives then ~6 months

37
Q

What is the prognosis for a patient with hermangiosarcoma of the right atrium resulting in pericardial effusion and cardiac tamponade?

A
  • Pericardiocentesis
  • Can’t be surgically resected
  • Tx with doxorubicin gives them ~ 3-4 months

Owner usually elects for euthanasia due to poor prognosis

38
Q

Most common breed associated with chemodectomas?

A

Brachycephalics

39
Q

What disease resolves in 50% of dogs after initial pericardiocentesis?

A

Idiopathic pericarditis

40
Q

What is a congenital pericardial disease that can be seen in cats?

A

Perineopericardial Diaphragmatic hernia (PPDH)

41
Q

What is the treatment protocol for a patient with perineopericardial Diaphragmatic hernia (PPDH)

A

If asymp - no tx needed
If symp - surgical correction

42
Q

What is PPDH?

A

Abnormal opening between the pericardial sac and peritoneal cavity resulting in herniation of the liver, gall bladder, diaphragm, etc

43
Q
A

SEM 5: SAM 1 (26 decks)

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