exam 1 - CV emergencies Flashcards
2 types of heart failure
congestion/backward failure
low output/forward failure
when does HF happen
when heart is unable to meet metabolic demands of peripheral tissues or can only do so in the presence of increased venous filling pressures
causes of heart failure
valvular dz, myocardial dz, congenital heart dz, arrhythmias, endocarditis, sepsis
history with CHF
increase respiration and effort
cough
exercise intolerance
syncope
abdominal distension
history with forward failure
weakeness
depression
exervise intolerance
lethargy
syncope
PE with dogs with CHF
increased RR/RE
tachycardia
murmur
increased lung sounds
can have - crackles, hypothermia, arrhythmias, ascites
PE for dogs with forward failure
tachycardia
murmur
poor pulses
cool extremities
prolonged CRT
dull
may have - hypothermia, arrhythmias
PE cats
tachypnea
increased resp effort
tachy or bradycardia
hypothermia
may have - mumur, gallop, increased lung sounds, muffled lung sounds, arrhythmias
Dx for heart failure
POCUS, thoracic rads, ECG, BP, SpO2, bloodowrk, echo
what does POCUS measure
LA enlargement
LA:aorta
1.6-2 = significant
what else can POCUS find
effusions, B-lines
does POCUS replace echo
no
HF tx goal
improve oxygen delivery
reduce preload, control edema and effusions, improve pump function, reduce afterload
Tx for HF in all patients
furosemide - loop diuretic
oxygen
pimobendan - Ca sensitizer and PDE3 inhibitor
tx for HF in decompensated pt
furosemide, oxygen,
nitro - mixed vasodilator/venodilator
dobutamine - beta agonist
1 DDx for feline arterial thromboembolism
cardiomyopathy
other DDx for feline arterial thromboembolism
neoplasia, FB, idiopathic
feline ATE locations
90% hindlimbs - 69-80% bilateral
10% brachial - R more common
renal, splanchnic, cerebral
history for feline ATE
+/- history of cardiac disease
acute onset paresis or plegia
lameness
vocalization
+/- respiratory signs
PE for feline ATE
5 Ps
pain, pulseless, pallor, polar, paralysis
diagnostics for feline ATE
doppler
paired blood glucose - lower in affected limbs
paired lactate - higher in affected limbs
US
tx for feline ATE
PAIN MANAGEMENT
anticoagulants, antithrombotics, +/- CHF management
prognosis feline ATE
negative indicators
>1 limb, hypothermia, lack of motor function, CHF
survival for feline ATE
27-39%
outcomes for feline ATE
25-35% euth, 28-40% natural death
50% cats regain motor function over 4-6 wks
whats more common, thrombosis or thromboembolism in dogs
thrombosis
causes of pericardial effusion
neoplasia, idiopathic, LA rupture, infectious, coagulopathy, CHF
what collapses first in pericardial effusion - R or L heart
R heart
acute history for pericardial effusion
collapse, weakness, sudden death, vomiting, lethargy
chronic history for pericardial effusion
abdominal distension, exercise intolerance, latheragy, decreased appetite, may be asymptomatic
PE findings in pericardial effusion
shock - obstructive
muffled heart
jugular distension
pulsus paradoxus
tachycardia
diagnostics for pericardial effusion
POCUS, ECG, BP, echo, rads, cbc/chem/coag
tx for pericardial effusion
pericardiocentesis, IV fluid bolus, NO LASIX (decreases preload)
overnight in hospital for observation
