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cardiopulmonary test 4 > LA valve disease > Flashcards

LA valve disease Flashcards

1
Q

What is the most common valve disease in large animals?

A

valvular insufficiency

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2
Q

What does valvular insufficiency result in?

A
  • exercise intolerance
  • arrhythmias
  • CHF
  • pulmonary hypertension
  • death
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3
Q

What are the etiologies of valvular insufficiency?

A
  • DVD
  • functional (LV dilation)
  • endocarditis
  • congenital dysplasia
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4
Q 
Degenerative valve disease results in the loss of what from the valvular leaflet?
A. Collagen
B. Proteoglycans
C. Muco-polysacharrides
D. Glycoaminoglycans
E. Elastin
A

A collagen

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5
Q

What valves are affected in DVD in horses?

A

mitral > aortic

right-sided rare

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6
Q

Mitral regurgitation in horses results in what type of hypertrophy?

A

eccentric hypertrophy due to volume overload

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7
Q

What is the pathophysiology of mitral regurgitation in horses?

A

increased left atrial pressures

  • left atrial chamber dilation
  • impede pulmonary venous drainage
  • atrial myocardial necrosis and fibrosis
  • pulmonary hypertension
  • pulmonary artery vasoconstriction
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8
Q

What are the clinical signs of mitral regurgitation in horses?

A
  • decreased performance capacity
  • signs of L-CHF
  • signs of R-CHF
  • collapse
  • sudden death
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9
Q

Which statement about pulmonary hypertension is correct?
A. Results in right sided CHF
B. Results in syncope
C. May be triggered by mitral regurgitation
D. Results in sudden death secondary to rupture of pulmonary artery
E. All of the above

A

E. all of the above

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10
Q

What is found on PE of mitral regurgitation?

A
  • systolic, left apical murmur
  • crackles on lung auscultation
  • pulmonary edema or pitting edema
  • jugular distension
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11
Q

What is the prognosis of mitral regurgitation in horses?

A
  • if mild, good prognosis
  • if moderate, guarded prognosis and likely to have clinical signs with strenuous activity
  • if severe, grave prognosis and likely to have clinical signs at rest
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12
Q

What is the therapy for mitral regurgitation in horses?

A
  • treat CHF (furosemide and digoxin)
  • treat atrial fibrillation (digoxin)
  • activity restriction for moderate/severe
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13
Q

When should horses with mitral insufficiency never be rode?

A
  • signs of cardiovascular compromise at rest (tachycardia, poor perfusion, arrhythmia)
  • have CHF
  • have pulmonary hypertension
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14
Q

Which animal is safe to exercise?
A. Horse with moderate MR but no signs at rest
B. Horse with moderate AI and HR of 60 bpm at rest
C. Horse with moderate pulmonary hypertension
D. Horse with managed CHF
E. Horse with atrial fibrillation and resting HR of 80 bpm

A

A. Horse with moderate MR but no signs at rest

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15
Q

What is aortic insufficiency in horses?

A
  • secondary to DVD
  • nodular thickening of leaflets
  • fibrous bands involving the valve leaflets occur
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16
Q

What is the pathophysiology of aortic insufficiency in horses?

A
  • pressure and volume overload to LV
  • total stroke volume increased
  • chamber dilation
  • systolic dysfunction
17
Q

What are the clinical signs of aortic insufficiency in horses?

A
  • decreased athletic performance
  • collapse (severe form)
  • signs of heart failure (severe form)
18
Q

What is found on PE of aortic insufficiency in horses?

A
  • diastolic murmur with decrescendo shape

- bounding arterial pulses

19
Q

What is the prognosis for aortic insufficiency in horses?

A
  • moderate to severe cases need exercise restriction

- advanced cardiovascular changes should not be exercised

20
Q

What is tricuspid regurgitation in horses?

A
  • secondary to DVD
  • athletic hypertrophy
  • pulmonary hypertension

(rare and well tolerated by horses)

21
Q

What are the clinical signs of tricuspid regurgitation in horses?

A
  • chamber dilation associated with athletes (athletic hypertrophy)
  • decreased athletic performance
  • ventral edema
  • jugular pulsations
22
Q

What is found on PE of tricuspid regurgitation in horses?

A

right sided systolic murmur (similar to murmur of VSD)

23
Q

What is the prognosis for horses with tricuspid regurgitation?

A

usually excellent unless there are clinical signs of complications

24
Q

What is pulmonic insufficiency in horses?

A
  • rarely results in a murmur or clinical signs

- guarded prognosis if secondary to pulmonary hypertension or concurrent CHF

cardiopulmonary test 4 (11 decks)

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