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RUSVM LAM I > Equine Murmurs > Flashcards

Equine Murmurs Flashcards

1
Q

What is the most common physiologic murmur of the horse?

A

Grade III/VI or less left heart base systolic ejection murmur

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2
Q

What is the most common congenital cardiac defect in foals?

A

Ventricular septal defect

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3
Q

What is the murmur associated with VSD?

A

III-IV/VI coarse, band shaped, pan-systolic murmur

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4
Q

What is the most sensitive and specific diagnostic test for VSD?

A

2D echo

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5
Q

What is the murmur associated with PDA?

A

Grade III-IV/VI continuous murmur over left heart base

“Machinery Murmur”

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6
Q

When is the ductus arteriosus normally closed in horses?

A

within first 72-96 hours of birth

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7
Q

What is the closure of the DA triggered by?

A

increased arterial O2 tensions and decreased flow

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8
Q

T/F: Valvular insufficiency in the horse can occur both in the presence and absence of cardiac pathology

A

TRUE

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9
Q

What is the most frequent cause of mitral valve insufficiency?

A

Degenerative changes to valve

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10
Q

What is the most common site for bacterial endocarditis in equine?

A

Mitral valve

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11
Q

What are CS associated with aortic insufficiency?

A

N/A-typically asymptomatic

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12
Q

What is the most common murmur identified in national hunt horses?

A

Tricuspid insufficiency

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13
Q

What are the most commonly affected valves for vegetative endocarditis?

A

Mitral and aortic

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14
Q

What are the common bacterial isolates found in vegetative endocarditis?

A

Strep spp., Actinobacillus equuli, Escherichia coli

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15
Q

What is the minimum time frame for treating vegetative endocarditis?

A

4-6 weeks

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16
Q

What are the initial Ab used for vegetative endocarditis and then common secondary Ab?

A

K-pen IV and gentamicin

Cefotaxime, rifampin and TMS

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17
Q

What are anti-inflammatory drugs used in vegetative endocarditis?

A

phenylbutazone or flunixin meglumine

18
Q

What are four causes of CHF in horses?

A

Myocardial dysfunction, acquired valvular dysfunction/disease, pericardial effusion, congenital cardiac disease

19
Q

What is the most common type of heart failure in the horse?

A

Volume overload resulting in progressive ventricular dilatation

20
Q

What is dilatation?

A

Increase in myocardial cell number and length

21
Q

An increase in afterload leading to increase in myocardial cells laid in parallel fashion is known as what?

A

Pressure overload

22
Q

What is a cause of pressure overload?

A

semilunar valvular stenosis (rare)

23
Q

T/F: In a failing heart, increases in filling increases the stroke volume

A

FALSE- when filling is increased it DOES NOT increase SV

24
Q

T/F: Horses typically have CS of both R&L sided CHF?

A

True

25
Q

What are three goals of CHF treatment in equine?

A
  1. improve tissue perfusion=increase CO
  2. promote excretion of excess fluids
  3. maintain oxygenation
26
Q

What is the most common positive inotrope used in horses?

A

Digoxin- inhibits Na/K/ATPase resulting in increase in intracellular Na and increase intracellular Ca
Dose dependent

27
Q

What are factors predisposing a horse to digoxin toxicity?

A

decreased plasma protein binding, hypokalemia/hypomagnesemia, dehydration, renal disease

28
Q

What is the treatment for digoxin toxicity?

A

Fab antidigoxin antibodies

29
Q

What does dobutamine do and when is it typically used?

A

Increases contractility–> Inc. SV

Used w/ septic shock in foals and for horses with acute failure temporarily

30
Q

What is the MOA of furosemide?

A

inhibits Na, K and Cl reabsorption in ASCENDING LOOP of Henle-increasing excretion of electrolytes and water

31
Q

What is the more potent form of furosemide?

A

Bumetamide

32
Q

What are some bacterial, viral and parasitic causes of myocarditis?

A

Bacterial- slmonella and clostridium
Viral- influenza, EVA, EIA, AHS
Parasitic- Strongylosis and borrelia burgdorferi

33
Q

What is a nutritional cause of myocarditis?

A

Vit E/Se

34
Q

What are the three forms of pericarditis?

A

Effusive
Constrictive
Effusive-constrictive

35
Q

What are causes of effusive pericarditis?

A

Trauma, inflammation, neoplasia and idiopathic (most common)

36
Q

Fibrinous pericarditis is also known as what form of pericarditis?

A

Constrictive pericarditis

37
Q

What is the HR in effusive pericarditis vs. constrictive pericarditis?

A

Effusive: 50-80
Constrictive: 60-100

38
Q

Severity of CS in effusive pericarditis are directly linked to what?

A

absolute amount of fluid present and rate of accumulation

39
Q

Why is venous return impaired through the cardiac cycle of a patient with effusive pericarditis?

A

Decreased diastolic filling due to decreased myocardial stretch leading to decreased SV and force of contraction

40
Q

Explain why there is a decreased CO in a patient with constrictive pericarditis?

A

Initial diastolic fillin is unimpaired, but when critical volume is reached expansion is restricted and filling ceases abruptly, resulting in decreased preload –> decreased CO

41
Q

Ingestion of a new batch of hay or grain is typical of this

A

Ionophore toxicity

42
Q

What is contraindicated in inophore toxicity?

A

Digoxin
Both digoxin and inophores cause Ca influx- they work together when both given and lead to cell death and myocardial necrosis

RUSVM LAM I (9 decks)

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