LA vascular disorders

Question 1

What is aortic root disease?

Answer 1

• group of disease entities of proximal aorta
• aortic aneurysms
• aortocardiac fistulas
• complete rupture of the aortic root

Question 2

What causes aortic aneurysms?

Answer 2

• develop secondary to connective tissue degeneration within aortic wall
• can be congenital deformity of the media of the aorta and annulus fibrosis

Question 3

What happens in aortic aneurysms?

Answer 3

• defect in junction of aortic root at base of ventricular septum
• above aortic valve leaflet
• focal dilation or ballooning of the aortic wall
• usually R coronary sinus involved

Question 4

What is the significance of finding an aortic aneurysm?

Answer 4

• aneurysm may rupture at any time

- horses are regarded as unsafe for exercise, riding, and breeding

Question 5

What is an aortocardiac fistula?

Answer 5

• ruptured sinus of valsalva or ruptured aortic aneurysm

- results in a communication between the aorta and either the RV, RA, or LV

Question 6

What are the clinical signs of an aortocardiac fistula?

Answer 6

• signs mimic colic or distress (sweating, pawing, abdominal pain, etc.)
• tachycardia
• cardiac murmurs
• signs of CHF

Question 7

What is the treatment of aortocardiac fistulas?

Answer 7

address complications

Question 8

What is the prognosis of aortocardiac fistulas?

Answer 8

guarded to grave, many are euthanized or die in days to months

Question 9

What happens with complete rupture of the aortic root?

Answer 9

results in sudden death!

Question 10

Which statement on aortic aneurysms is correct?
A. Most aneurysms are acquired secondary to connective tissue abnormalities
B. Horses with aneurysms are not safe to exercise
C. Rupture of the aortic aneurysm may result in signs of colic and a load heart murmur
D. Aneurysms tend to rupture during activity
E. All of the above

Answer 10

E all of the above

Question 11

What can cause pulmonary hypertension?

Answer 11

• chronic L CHF
• primary lung disease
• pulmonary thromboembolism
• hypoxia induced vasoconstriction
• congenital heart disease
• exercise (EIPH)

Question 12

What are the clinical signs of pulmonary hypertension?

Answer 12

• reflect underlying disease process
• R CHF
• syncope
• sudden death

Question 13

What is seen on PE of pulmonary hypertension?

Answer 13

• R CHF
• split S2
• murmur
• respiratory abnormalities

Question 14

What is thrombophlebitis?

Answer 14

inflammation/damage of a peripheral vein with subsequent thrombosis

Question 15

What most commonly causes thrombophlebitis?

Answer 15

• venipuncture
• catheterization
• trauma
• hypercoagulable state

Question 16

What are the clinical signs of thrombophlebitis?

Answer 16

• heat, swelling, pain of affected vein and area
• distal distension of vessel
• distension of draining vessels
• edema over affected area

Question 17

What is the therapy for thrombophlebitis?

Answer 17

• antibiotics if infection present
• NSAIDs
• hot packing
• DMSO
• rest

Question 18

What is the prognosis for thrombophlebitis?

Answer 18

good but it can predispose to valvular endocarditis

Question 19

What is an arterial thromboembolism?

Answer 19

• embolization of thrombus in arterial bed

- the aorto-iliac thrombosis is the most common site

Question 20

What are the clinical signs of arterial thromboembolism?

Answer 20

• ataxia
• collapse
• hindlimb weakness
• hindlimb edema/pain

Question 21

How do you treat arterial thromboembolisms?

Answer 21

• stall rest
• anti-inflammatory medications
• thrombolytics

Question 22

What is the prognosis for arterial thromboembolisms?

Answer 22

guarded