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SAM Module A Cardiology > Intro to heart disease > Flashcards

Intro to heart disease Flashcards

1
Q

What causes weak pulses?

A

reduced cardiac output

  • Systolic dysfunction
  • Outflow obstruction
  • pulmonic stenosis

• Hypovolaemia

  • Haemorrhage
  • Septic shock…

• Hypertension

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2
Q

What kind of pulse do you get with a PDA?

A

Waterhammer

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3
Q

What is the hepatojugular reflex?

A

In right sided failure
Pressure on the cranial abdomen = increased venous return to the RHS of the heart
See pulsation rise up the jugular groove/ jugular distension

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4
Q

What to systolic murmurs suggest in different areas in the heart?

A

Left apex - mitral regurge/ VSD
R apex - tricuspid regurge
L base - outflow tract obstruction/ pysiological murmur/ PDA (constant)
R base - VSD (v forward)/ aortic or pulmonic stenosis

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5
Q

What are the ddx for a left apex murmur?

A 
Valvular disease
•Degenerative
•Dysplastic
Annular stretch (dilation)
•DCM
•PDA, MDVD etc...
Ventricular hypertrophy
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6
Q

What are the DDx for a right apex (tricuspid regurge) murmur?

A

Valvular disease
Annular stretch
Ventricular hypertrophy
NB Pulmonary hypertension can produce a loud murmur, the rest tend to be quieter

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7
Q

What are the ddx for a left base murmur?

A

Aortic stenosis
Pulmonic stenosis
Physiological
•Conformation (v large dogs having sinus arrhythmia may have a pause then murmur)
•Heart rate
•Blood viscosity (e.g. anaemia/ hyperproteinaemia)
•High output states (e.g. pyrexia)

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8
Q

What is mitral regurge associated with in cats?

A

HCM

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9
Q

What are the primary heart disease ddx for murmurs in cats?

A

Dynamic left or right ventricular outflow tract obstruction
Obstruction caused by any other hypertrophied structures
• Mitral regurgitation
• Tricuspid regurgitation
• Congenital heart defect

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10
Q

What are the non cardia ddx for murmurs in cats?

A

IVFT
hyperthyroidism
anaemia

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11
Q

What are the ddx for diastolic murmurs?

A 
Apex
• Mitral stenosis
• (Tricuspid stenosis)
•Base
• Aortic regurgitation
• PDA
• (Pulmonic regurgitation)
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12
Q

What are the 5 categories of Ddx for tachypnoea/ dyspnoea/ cough?

A 
URT (obstruction)
Airwarys
pulmonary parenchyma
pleural space
other
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13
Q

What are the ddx of airway disease causing tachypnoea/ dyspnoea?

A 
Bronchial  disease
• Inflammatory
• Feline asthma
• Infectious
Neoplastic
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14
Q

What are the ddx of pulmonary parenchyma disease causing tachypnoea/ dyspnoea?

A 
Oedema
• Cardiac
• Non‐cardiogenic - strangulation/ electrocution/ seizure
Cellular infiltrate
• Pneumonia - Viral/bacterial/parasitic
• Neoplasia
• Haemorrhage
Fibrosis
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15
Q

What are the ddx of pleural space disease causing tachypnoea/ dyspnoea?

A 
Effusion
• Cardiac
• Pyothorax
• Neoplastic
• Chylothorax
Pneumothorax
Mass  lesions - lymphoma and mesothelioma most common
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16
Q

What are the ddx of ‘other’ diseases causing tachypnoea/ dyspnoea?

A
  • Acidosis
  • Respiratory muscle failure
  • Pyrexia
  • Respiratory compromise
  • Ascites
17
Q

What are the URT ddx for cough?

A
  • Laryngeal paralysis

* Infectious tracheobronchitis

18
Q

What are the lower airway ddx for cough?

A

Bronchial disease

Cardiac enlargement

19
Q

What are the pulmonary parenchyma ddx for cough?

A 
Oedema 
• Cardiac
• Non‐cardiogenic
Cellular infiltrate
• Pneumonia - Viral/bacterial/parasitic
• Neoplasia
• Haemorrhage
Fibrosis
20
Q

What are the pleural space ddx for cough?

A 
Pleural space
• Mass lesions
Mediastinum
• Mass lesions
• Inflammation
21
Q

What are the ‘other’ ddx for cough?

A

Pharyngeal disease
Reverse sneeze
Vomit

22
Q

How can you differentiate a respiratory and cardiac cough

A

Cardiac - won’t have sinus arrythmia

  • cough at night often
  • tachycardia
  • possible murmur
  • exercise intolerance

Resp - cough on excitement/ exercise
- may be productive

23
Q

What are the main groups of ddx for collapse?

A 
Metabolic
Resp
CV
Musculoskeletal
Neuro
24
Q

What are the neuro ddx for collapse

A

Seizure
narcolepsy
transient ischaemic attack
Stroke

25
Q

What are the musculoskeletal ddx for collapse?

A 
Myopathies
• Exercise‐induced collapse
• Muscular dystrophy
• Myositis
Neuromuscular transmission disorders
• Myasthenia gravis
• Botulism
• Toxins
Peripheral neuropathies
Orthopaedic disease
26
Q

What are the metabolic ddx for collapse?

A

Addisons
Anaemia
Lytes - Na, K, Ca
Low BG

27
Q

What are the resp ddx for collapse?

A 
Mostly URT obstruction (e.g. BOAS)
• Hypoxia
Upper airway obstruction
Parenchymal disease
Pleural space disease
• Pulmonary hypertension
Congenital
Severe pulmonary disease
Angiostrongylus
Congestive heart failure
• Cough‐induced syncope
28
Q

What are the CV ddx for collapse?

A

Reduced cardiac output
• Outflow obstruction e.g. pulmonic/ aortic stenosis
• Tachyarrhythmia/ bradyarrhythmia
• Reduced systolic function - rare
• Impaired diastolic filling e.g. cats with HCM/ pericardial effusion

Low peripheral resistance
• Neurally mediated syncope - vasodilation + bradycardia
• Massive vasodilation - Anaphylaxis, Sepsis

29
Q

What should be the approach to syncope with no obvious cause?

A

Bloods (including AChr Ab)
BP
Holter
Echo (even without murmur)

30
Q

Outline the use of troponin in testing

A

Shows cardiac myocyte damage
Sustained or high levels = poorer prognosis
Used for: DCM - dx and px
MVD - px
arrhythmias - mostly ventricular and supraventricular
Mycocarditis (v high)
Myocardial infarction

Not specific for caridac disease - can go up with IMHA, GVD etc

31
Q

Outline the use of NT pro BNP

A

used for ventricular stretch/ hypoxia,
Performs better than troponin in determining if cardiac disease is present
Aids Px and Dx

SAM Module A Cardiology (13 decks)

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