Lecture 16 9/19/24

Question 1

What are the general characteristics of pericardial disease?

Answer 1

-uncommon
-important cause of clinical signs of right-sided CHF

Question 2

What is the parietal pericardium?

Answer 2

fibrous pericardium + serosal layer

Question 3

Why is pericardial disease important?

Answer 3

causes diastolic dysfunction and congestive heart failure

Question 4

What is the etiopathogenesis of pericardial effusion in cats?

Answer 4

-venous congestion associated with CHF
-FIP
-neoplasia

Question 5

What is the etiopathogenesis of pericardial effusion in dogs?

Answer 5

-neoplastic*** (>50%)
-idiopathic hemorrhagic effusion
-coagulopathy
-uremia
-coccidioidomycosis

Question 6

What is the pathophysiology of pericardial effusion?

Answer 6

-effect of PE depends of volume of effusate and compliance of pericardium
-slower development of PE allows pericardium to stretch and accommodate fluid at low pressure
-if volume of PE exceeds reserve volume, intrapericardial pressure rises and can impair ventricular filling

Question 7

What is tamponade?

Answer 7

syndrome of impaired ventricular filling caused by presence of intrapericardial fluid

Question 8

What causes the clinical signs of tamponade?

Answer 8

low cardiac output and elevated venous pressure

Question 9

How does PE impact ventricular filling pressures?

Answer 9

PE causes RV filling pressures to equilibrate with those of the LV before the two begin to rise in tandem

Question 10

What is pulsus paradoxus?

Answer 10

-exaggeration of physiologic respiratory associated changes in arterial pressure
-augmented right ventricular filling during inspiration occurs at the expense of left ventricular filling
-weak pulses with inspiration, stronger with expiration

Question 11

What is the history/signalment of PE?

Answer 11

-large/giant breeds
-ascites
-weakness/syncope
-lethargy
-inappetence
-circulatory collapse

Question 12

What are the physical findings with PE?

Answer 12

-tachycardia
-muffled heart sounds
-ascites
-jug. distention
-weak arterial pulse

Question 13

What are the characteristics of central venous pulse?

Answer 13

-pulsation is physiologic
-degree of distention and the height of jug. pulsation reflects RA pressure

Question 14

How is PE diagnosed on chest rads?

Answer 14

-cardiac silhouette enlargement
-silhouette lacks contour
-pulmonary vessels are small

Question 15

How is PE diagnosed on ECG?

Answer 15

sinus tachycardia +/- abnormal QRS
-small QRS

Question 16

Why is echo important for PE assessment??

Answer 16

allows for hemodynamic and etiologic assessment

Question 17

How is PE diagnosed on echo?

Answer 17

presence of circumferential free space that is generally not visible caudal to the left atrial parietal wall

Question 18

What are the consequences of pleural effusion, based on effect on filling?

Answer 18

-atrial inversion
-RV inversion
-LV chamber size
-heart rate

Question 19

Where does hemangiosarcoma typically occur?

Answer 19

parietal wall of right atrium

Question 20

Where does chemodectoma typically occur?

Answer 20

periaortic

Question 21

Which neoplasms can cause pleural effusion?

Answer 21

-hemangiosarcoma
-chemodectoma
-mesothelioma
-lymphosarcoma

Question 22

What is the treatment for PE?

Answer 22

-pericardiocentesis
-subtotal pericardiectomy
-balloon pericardiotomy

Question 23

Why are diuretic agents contraindicated in PE treatment?

Answer 23

reduce venous pressure and further limit ventricular filling