Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Equine Murmurs > Flashcards

Equine Murmurs Flashcards

1
Q

What are the 3 main causes of murmurs in horses?

A 
> normal (physiological) 
- functional flow murmur due to valve regurgitation 
> valve pathology
- endocardiosis (degeneration) 
- bacterial endocarditis
- valve prolapse
- ruptured chordae tendinae
- valve regurgitation 2* to ventricular dilation 
> congenital 
- VSD
- PDA, Valvular dysplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are you looking for on auscultation of murmurs?

A
  • timing, intensity, PMI (point of maxmimum intensity)
  • pitch and quality
  • radiation
  • precordial thrill (“buzzing” with hand on chest)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which heart sounds are normally audible in the horse?

A

SI, S2, S3, S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the gold standard for murmur diagnosis? What else may be used diagnostically?

A

> Echo
- assess severity of lesion, confirm dx
- determine prognosis and suitability for ridden exercise
electrocardiography
- allow assessment of concurrent arrhythmias (not useful for murmur itself)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can 2D and M mode echo be used for?

A
  • assess valve structure and function (prolapse)
  • assess chamber size (enlargement/colume overlaod)
  • assess myocardium (hypertrophy)
  • monitoring progression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can Doppler (spectral and colour flow) echo be used for?

A
  • semi-quantitive assessment of valvular regurgitation

- volume and velocity of regurgitant jets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are physiological flow murmurs? Which horses commonly experience this?

A
  • mainly TB horses in training
  • mainly mitral and tricuspid valves (on auscultation)
  • can also be aortic and pulmonic valves (on echo)
    > these msut be differentiated from regurgitant murmurs due to pathology!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common congential abnormality in the horse?

A

Septal defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What types of physiological flow murmurs are possible? When would these be heard and what would they sound like?

A

> aortic flow
- early-mid systolic [S1-S2] crescendo-decrescendo
- common
- quiet, local radiation only
- PMI heart base
- changes with exercise (usually disappears!)
- normal esp. in fit horses (1/3 TBs will have this)
ventricular (mitral and tricusp) flow
- early diastole (S2-S3)
- less common
- short duration, high pitched squeak
- PMI heart base or AV valves, L/R
- normal esp. young TB in training
remember they may also be associated with valve pathology and be sudden onset or cause collapse and death!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which myocardial diseases common in small animals do not ococur in the horse?

A

Stenosis and pulmonary valve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which valves are more / less likely to regurgitate in horses?

A

mitral>tricuspid>aortic
- due to different pressures placed on the valves eg. mitral closed during systole, aortic only has to hold back blood in aorta during diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why may mitral regurgitation lead to collapse and sudden death?

A

Pulmonary artery rupture due to ^ pressures if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do mitral regurgitation murmurs vary with severity?

A

intensity and radiation ^ (1-6 /6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What shape are mitral and tricuspuid murmurs?

A

Plateau (band) shaped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What types of mitral and tricuspid regurgitation murmur are heard at different times?

A
  • partial (early or mid systole)
  • holo-systolic (S1-S2)
  • pan-systolic (S1 buried)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PMI mitral regurge? radiates?

A

left 5th intercostal space

- radiates caudodorsally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PMI tricuspid regurge? radiates?

A

right 4th intercostal space

- radiates craniodorsally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is aortic regurgitation often due to? Which horses are commonly affected?

A
  • rarely functional
  • often due to endocardiosis
  • older horses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of disease is endocardiosis?

A

Progressive, intensity and radiation increase with severity -> eventually euthanized

20
Q

Intensity, timing, shape and PMI and radiation of aortic regurgitation?

A
  • grade 1-6
  • timing holodiastolic (S2 - S3/4)
  • shape decrescendo
  • PMI: aortic valve (left basal area)
  • radiation: caudoventrally to RHS (as aortic arch curves left - right)
21
Q

When may mitral regurgitation be significant?

A
  • poor performance
  • resting tachycardia
  • abnormal pulse quality, slow CRT
  • signs of decompensated LCHF
  • arrhythmias concurrently, esp. atrial fibrillation (due to volume and pressure overlaod -> atrial dilation)
  • if louder than grade 4
  • wide radiation
22
Q

What is the normal HR of a horse?

A

30-40 (>50 = tachycardia)

23
Q

When may tricuspid regurgitation be significant?

A
  • poor performance
  • resting tachycardia
  • abnormal pulse
  • signs of decompensated RCHF
  • arrhythmias esp atrial fibrillation
  • > grade 4
  • wide radiation
24
Q

When may aortic regurgitation be significant?

A
  • poor performance
  • resting tachycardia
  • bounding (hyperkinetic) arterial pulse (due to large systolic/diastolic pressure difference from the regurgitation)
  • slow CRT
  • signs of LCHF
  • arrhythmias, esp atrial fibrillation
25
Q

What is the commonest form of valve pathology in horses? Which valves are usually affected?

A
  • degenerative valvular heart disease 9endocardiosis)
  • aortic valves mainly
    > remember many valve regurgitations ARE NOT PATHOLOGICAL IN HORSES
26
Q

Which animals are commonly affected by bacterial endocarditis?

A

> ruminants
- 2* to liver abscess, joint ill, metritis, mastitis, traumatic reticuliltis, naval abscess
horses less commonly
- site of sepsis often not IDed
- septic jugular thrombophlebitis from IV catheters possible

27
Q

Why is prompt tx of bacterial endocarditis necessary?

A

large proliferative vegetative lesions develop, limiting return of valve function

28
Q

How is Dx of bacterial endocarditis performed?

A 
> clinical signs
- CHF
- fever
- cardiac murmur
- tachycardia and tachypnoea
> lab
- hyperfibrinogenaemia, anaemia, leucocytosis
- blood culture (3x due to false negative) ideally when pyrexic, sterile collection (not via indwelling catheter)
29
Q

Tx of bacterial endocarditis?

A

broad spec Abx based on sensitivity

30
Q

prognosis of bacterial endocarditis?

A

guarded even after bacteriological cure

  • permenant structural damage to valve
  • in horses ,some right sided lesions may allow return to performance
  • septic emboli may spread to distant sites (lungs from RH, kidneys/joints from LH)
31
Q

Is valve prolapse pathological or physiological? which valves are affected? How is it diagnosed?

A
  • physiological (relates to function of valve)
  • NON-PROGRESSIVE regurgitation
  • all valves can be affected
  • may cause audible murmur
    > diagnose on echo
32
Q

Why may ruptured chordae tendinae occour?

A
  • spontaneous

- 2* inflammatory or degenerative changes in chordae

33
Q

which valves most commonly affected by ruptured chordae tendinae?

A

mitral

34
Q

What is ruptured chordae tendinae characterised by? Prognosis?

A
  • severe regurgitation with rapid change in haemodynamic status
  • acute cardiac failure or sudden death
    >Prognosis
  • can cpmpensate in long term if live beyond acute crisis, depending where chord is ruptured (close to papillary mm/leaflet edges)
35
Q

When may AV regurgitation develop 2* to other disease?

A
  • severe ventricular dilation (annulus ^ size)
  • cardiomyopathy and myocardial disease
  • aortic regurgitation and LV volume overload
    > AV valve regurgitation appars later in disease (important to ID 1* cause of problem)
36
Q

How can left ventricular volume overload be identified on echo?

A

ventricle become globoid shape with rounded apex

37
Q

What situation may a transient mutmut be detected?

A

Hypovolaemia

  • many horses presenting with acute colic/systemic disease develop cardiac murmurs
  • these resolve once 1* disease has been treated
38
Q

What type of physiological regurgitation may be seen in athletes? which valve commonly affected?

A
  • RV/LV hypertrophy
  • tricuspid
  • usually mild and non-progressive
39
Q

What are the 3 most common congenital abnormalities in horses? Which is MOST common?

A
    • ventricular septal defect most common
  • PDA
  • valve dysplasia
40
Q

Where is VSD found?

A

dorsal membranous septum

41
Q

What type of murmur is VSD?

A 
Diagonal (2 murmurs) 
> LHS murmur due to RV overload  (sounds like pulmonic stenosis, kind of functional pulmonic stenosis due to ^ blood in RA) 
- holo-pansystolic
- cres-decresc
- grade 3-6
- wide radiation
> RHS murmur due to LV-RV shunt
- holo-pansystolic
- coarse
- plateaued 
- grade 3-6
- PMI tricuspid valve 
- wide radiation
42
Q

How does intensity of VSD murmurs reflect severity?

A

INVERSELY proportional

- small hole = big noise

43
Q

Does VSD affect performance?

A

May do but if small defect may not be noticed and horse may enter training
- keep this on differentials!!

44
Q

how long is the ductus arteriosis normally patent for?

A

7-10d old foals

- closes earlier in farm animals

45
Q

What type of murmur does PDA make?

A

washing machine continuous murmur

  • grade 3-5
  • wide radiation
  • PMI left heart base
  • radiates to RHS

Cardiovascular (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions