Exam 4 - Pericardial Disease Flashcards
what are the main etiologies of pericardial disease in dogs?
acquired - effusion
what are the main etiologies of pericardial disease in cats?
acquired, effusion - congestive heart failure
what are the most common causes of pericardial effusion in the dog?
neoplastic - hemangiosarcoma & chemodectoma
idiopathic
what are some rare causes of pericardial effusion in the dogs?
infectious - fungal, bacterial, & viral
metabolic - uremia, vasculitis, hypoalbuminemia
traumatic
hemorrhagic - coagulopathy
congestive heart failure
what is the pathophysiology of pericardial effusion?
impaired filling of the right heart causing poor cardiac output (exercise intolerance, weakness, collapse), & right-sided heart failure (ascites, hepatomegaly, +/- pleural effusion)
what 3 components make up beck/s triad in pericardial disease?
- distant heart sounds
- decreased blood pressure +/- pulsus paradoxus (decreased pulse with inspiration)
- distended jugular veins
what are some radiographic findings consistent with pericardial effusion?
large globoid silhouette, under-circulated lungs, & diminutive vasculature
what are some echocardiographic features of pleural effusion?
- hypoechoic region around the heart
- mass may be seen - failure to identify a mass doesn’t rule out neoplasia
- presence & location of a mass determines probable tumor type
- left ventricular +/- left atrial chamber sizes may be reduced
- other structural heart abnormalities consistent with CHF
what may be seen on ecg in a patient with pericardial effusion?
sinus tachycardia, ventricular arrhythmias, small QRS complexes, & electrical alternans
what may be seen on bloodwork in a patient with pericardial effusion?
anemia, increased lactate, low venous oxygen, & azotemia
what are some other differentials for pericardial effusion?
anything that causes right-sided heart failure/ascites - pulmonary hypertension, HW disease, DCM, tricuspid dysplasia
when performing a pericardiocentesis, what does the patient need as far as prep & monitoring?
sedation, iv fluids, continuous ecg, patient in left lateral or sternal
tap on right hemithorax!! may need an ultrasound to identify ideal location - sterile prep & local block (skin, intercostals, & pleura)
what are the potential complications of pericardiocentesis?
arrhythmias, cardiac perforation, coronary artery laceration, & lung laceration
what is the typical fluid analysis of pericardial fluid?
typically hemorrhagic - cytology is low yield but still recommended & culture/sensitivity may be indicated in some cases
what is the most common pericardial disease in the dog?
pericardial effusion
what is the most common etiology of pericardial effusion in the dog & cat?
dog - neoplasia
cat - CHF
in dogs with signs of right-sided heart failure, what differential must be considered?
pericardial effusion
T/F: the history & clinical signs of pericardial effusion can be non-specific & variable & maybe absent all together
true
when is an emergency pericardiocentesis indicated in an animal with pericardial effusion?
clinical & echocardiographic signs of cardiac tamponade secondary to pericardial effusion
what causes cardiac tamponade?
when the volume of pericardial effusion causes an increase in pressure in the pericardial space which impairs preload reducing cardiac output
what is the most common cause of congenital feline pericardial disease?
PPDH for congenital
what is the hepatojugular reflux test? what does a positive test mean?
identifying jugular venous distention while applying steady, firm pressure to the abdomen - suggestive of right ventricular systolic or diastolic dysfunction, tricuspid valve disease, or pericardial disease
