Equine Cardiology 1 Flashcards

1
Q

how fast can a horse run?

A

65km/h

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2
Q

equine heart size, and what this determines

A
  • 0.9 - 1.1% BWT
  • determines maximum stroke volume > cardiac output
    > aerobic capacity > exercise performance
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3
Q

oxygen delivery to tissues in the horse depends on?
how important is the spleen?

A
  • cardiac output
  • oxygen carrying capacity
    > spleen 12L or more of RBC
    > spleen size increased in racing horses
    > splenectomy reduces performance > no splenic contraction possible
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4
Q

systemic circulation horse volume, how much in veins and arteries at rest and with exercise? how much goes to skeletal muscle?

A

blood volume = 8-10% BWT
- 75% in circulation
> at rest, 60% in venous system, 15% arterial
- with exercise, redistribution
> skeletal muscle at rest 10-20%
> skeletal muscle with exercise 80-90%

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5
Q

equine heart rates and how they relate to parasympathetic / sympathetic systems

A

30-100 - parasympathetic withdrawl
100-204(-241) - sympathetic and catecholamine inputs
<><><>
241 is ~max HR
<><><>
- this is what happens as a horse starts to run

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6
Q

what happens with stroke volume as a horse goes from rest to running

A

rest: 2.0-2.5ml/kg, ~1L
running: 3/–4/0ml/Kg, ~2L

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7
Q

training response in horses

A

cardiovascular
- improved function
- increased cardiac output
> increased heart size
> increased stroke volume
<><>
musculoskeletal
- increased vasculature
- increased intramyocyte oxidative enzyme proliferation

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8
Q

diagnostic evaluation of a horse should look at:
(esp. regarding racing/ cardio complaints)
- electrocardiogram limitations?

A
  • history
    > medications? ionophores?
    <>
  • physical exam
    > respiratory changes?
    > check rest of body before heart
    > check jugular
    > listen to both sides of the heart
    > cardiac enlargement, displacement, murmurs? cardiac silhouette?
    <>
  • electrocardiogram
    > rate, rhythm, complexes
    > duration
    > perkinje fibers in horse penetrate all the way through the myocardium, wheras in other animals only 2/3 through > makes it harder/ impossible to pick up chamber dilation
    > can use devices to look over a longer time, or with exercise
    <>
  • ultrasound
    <>
  • routine blood analysis
    <>
  • other
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9
Q

what is cardiac triponin I?

A
  • specific isoenzyme we can pick up, low level released from myocytes all the time, increased level with breakdown, eg. with hypoxia
    > used in humans, validated in horses
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10
Q

what do the S1, S2, S3, S4 heart sounds come from?

A

S1 - associated with AV valve closure
S2 - associated with aortic and pulmonic valve closure
S3 - associated rapid ventricular filling
S4 - associated with atrial contraction
<><><><>
- sounds come from shifts in the volume of blood in the heart, not actually closure of valves

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11
Q

one way to place ECG leads

A

Base - apex lead

negative lead at minubrium
positive lead at xyphoid
ground lead on neck

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12
Q

what is a Q wave and what does it look like on an electrocardiogram? how is it placed relative to other waves?

A

depolarisation of the interventricular septum
<><>
- must be a negative deflection
- must be the first deflection of the QRS complex
- must be followed by an R wave
<><>
- there can only be one Q wave per QRS complex

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13
Q

what is an R wave and what does it look like on an electrocardiogram? how is it placed relative to other waves?

A

The R wave represents early ventricular depolarisation
<><>
- positive deflection
- all positive deflections are R waves and only R waves (within the QRS complex)
- there can be several R waves per QRS complex

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14
Q

what is an S wave and what does it look like on an electrocardiogram? how is it placed relative to other waves?

A

signifies the final depolarization of the ventricles, at the base of the heart.
<><>
- it must be a negative deflection
- it must follow an R wave
- there can be several S waves per WRS complex

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15
Q

what is a QS wave

A
  • it must be a negative deflection
  • there must be no R wave in the QRS complex
    > therefore it describes a QRS complex with only one deflection and this deflection is negative
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16
Q

variations in normal P wave appearance on horse ECG
(what does it represent)

A

represents the electrical depolarization of the atria of the heart.
<><><><>

  • monophasic - one hump
    > positive or negative
  • bifid - two humps
    > positive or negative
  • biphasic
    > positive then negative
    > negative then positive
17
Q

appearance of normal horse T wave
what does it represent

A

monophasic (positive, negative), biphasic
- horse can have tall wave
<><><><>
T wave represents the repolarization of the ventricles

18
Q

why can ther ebe multiple P waves in horse

A

atria are picking up just out of synch

19
Q

sinus arrhythmia - is it ok? why?

A

-normal in horse, associated with respiration

20
Q

what does first degree AV block look like on an electrocardiogram

A

prolonged P-R interval

21
Q

types of second degree AV block, what they look like on ECG, why they might occur

A

type 1- Mobitz type-1 (Wenckebach phenomenon)
> increasing P-R interval successively, and then a dropped beat ie. P wave but no QRS following
> due to high vagal tone / parasympathetic input
> can try to increase sympathetic input by startling, running…
<><>
type 2 - Mobitz type-2
> dont have progressive prolonging of P-R interval, just dropped beat
> more likely to be associated with pathology

22
Q

what is a third degree AV block, what does it look like on ECG

A

complete block; A-V dissociation
> P wave not associated with QRS, T complexes
> infiltrative disease with heart, usually. Rarer.

23
Q

wider and taller R & T wave is usually what?

A
  • ventricular premature complex, not necessarily abnormal
24
Q

atrial and ventricular premature contraction
- do we need to treat, if single vs multiple?

A
  • singular, occasional complexes - no treatment needed
    <><><>
  • multiple, frequent occurence:
  • assess underlying condition
    > electrolyte imbalances
    > cardiac troponin I
    > echocardiogram
    > holter monitor
    <>
    > Can be viral induced
    Tx - antiinflammatory therapy > NSAIDs, corticosteroids
25
Q

Irregular baseline on ECG means what?

A

atrial fibrilation
> myocytes just doing their own thing, no coordinated contraction
<><>
- no p waves, jagged baseline

26
Q

artial fibrillation in horses
- significance?
- observations?

A
  • # 1 cardiac cause of poor performance, common cause overall
  • irregular rhythm
  • S4 not present
  • variable pulse quality
    <><>
  • can start a race fine but will slow down and be passed
27
Q

atrial fibrillation in horses
- heart structure?
- cause?
- rate?

A
  • usually lone atrail fibrillation
  • normal cardiac structure
  • no apparent underlying cause
    > normal large heart
    > high vagal tone
    > electrolyte disturbances
    > medications
  • often have normal HR
28
Q

treatment of atrial fibrillation

A
  • Quinidine sulfate (PO)
  • Quinidine gluconate (IV)
  • other medications
    > none of these work well, can have side effects that are serious
    <><><>
  • Transvenous electrocardiogram (TVEC)
29
Q

quinidine salts mechanism of action

A
  • increase in sinus rate by cholinergic blockade or
  • increase in sympathetic activity
  • therapeutic doses cause use dependent blockade of fast Na+ channels and slowing of their reactivation
  • also has direct effect on reentrant arrhythmias
30
Q

quinidine salts side effects

A
  • tachycardia
  • tachypnea
  • nasal edema
  • sweating
  • colic
  • diarrhea
  • death
31
Q

Quinidine salts - how to avoid adverse events, what to do if you get into trouble

A

need to monitor patient closely
- clinical signs
- ECG
<><><
Treatment if get into trouble
- sodium bicarbonate
> increased protein binding of quinidine to albumin
> whereby decrease serum levels

32
Q

what is TVEC
- how does it work
- success rate vs quinidine

A
  • transvenous electrocardioversion
    > electrocatheters from jugulars passed into heart
    > first out left pulmonary artery
    > second in right atrium
    > trying to get maximum exposure across atria
    > then go under GA, radiograph to ensure catheter positioning
    > then use defribrillator to try and synch to a normal rhythm
  • 98% success rate to get horses back into normal rhythm
  • quinidine salts are 75-80%
    <><><>
  • not necessary to treat all horses for atrial fib > only those who are athletes