Pericardial disease Flashcards
How does the outer layer of the pericardium differ from the inner layer?
Outer - fibrous
Inner - serous
How much pericardial fluid is normal?
0.25m/kg
Give examples of pericardial effusion causes in dogs
Idiopathic - good prognosis, may never recur
Neoplasia - poor prognosis, likely to recur
(NOT CHF)
Give examples of pericardial effusion causes in cats
R-CHF FIP Infectious Lymphoma Mesothelioma, rhabdomyosarcoma Coagulation Uraemia
Idiopathic pericardial effusion is a diagnosis of exclusion. What breeds are predisposed?
St Bernard
Golden Retriever
Labrador
What is the treatment for a recurring, idiopathic pericardial effusion?
Pericardectomy
What breeds are predisposed to haemangiosarcomas?
Golden Retriever
German Shepherd
Irish Red Setters
Haemangiosarcomas are usually found in which organs?
Spleen
Liver
Right atrium
What is the treatment for haemangiosarcomas of the pericardium?
Palliative - pericardiocentesis
Chemotherapy +/- surgery (pericardectomy)
What is a chemodectoma?
BENIGN tumour of chemoreceptors on aortic body
Which breeds are predisposed to a chemodectoma?
Brachycephalics - due to chronic hypoxia?
Do chemodectomas require treatment? If so, what?
Benign but highly invasive
Tx: palliative pericardectomy
What is cardiac tamponade? What type of heart failure does it cause?
Pericardial effusion causes pressure on heart chambers
Results in R-CHF
What are the chronic clinical signs of pericardial effusion in dogs?
R-CHF: ascites, hepatojugular reflex, jugular distension, tachycardia
Weak femoral pulses, pulsus paradoxus
Muffled heart sounds
What are the acute clinical signs of a pericardial effusion in dogs?
Weak, collapsed Tachycardia Pale mms, shock \+/- arrhythmia Weak pulses (signs of forwards heart failure)
What drug cannot be used in dogs with a pericardial effusion, but can be used with cats?
Furosemide
Do NOT use in dogs with pericardial effusion - PE not due to CHF
What is the emergency treatment for pericardial effusions in dogs?
Pericardiocentesis
IV fluid therapy if haemodynamically unstable
What is the emergency treatment for pericardial effusion in cats?
Pericardiocentesis
Then furosemide
Can you use diuretics before, during or after pericardiocentesis?
NO - even after pericardiocentesis
Natural diuresis due to natriuretic peptide release
What haematological parameter should you always check before performing pericardiocentesis?
Check PCV
What sedative drugs are best to use to perform pericardiocentesis?
Opioids
butorphanol +/- midazolam if in CHF
Which intercostal space should you use for pericardiocentesis?
5-6
7-8 for pleural effusion
What local and what size catheter should be used for pericardiocentesis?
2% lidocaine for skin and plura
14G catheter
If an animal has recurrence or no marked improvement following pericardiocentesis, what is your most likely differential?
Neoplasia
What should you do if you are performing pericardiocentesis and the pericardial effusion PCV is the same as the blood?
STOP
Animal is haemorrhaging and you are draining blood
PCV should be different (either way) of blood
What is constrictive pericarditis?
Thickened and fibrotic pericardium
What can cause constrictive pericarditis?
Idiopathic
R-CHF
Secondary to recurrent pleural effusion
Name 1 dog breed and 1 cat breed predisposed to peritoneopericardial diaphragmatic hernia (PPDH)
Weimaraner
Persian
Peritoneopericardial diaphragmatic hernia PPDH is often an incidental finding but may be seen with what other abnormalities?
Sternal abnormalities
Abdominal hernias
Congenital heart disease
Advanced MDVD can cause left atrial rupture. What is the treatment and prognosis?
Pericardiocentesis, blood transfusion and thoracotomy
Guarded prognosis
Infectious pericarditis can be due to foreign bodies, wound penetration or infectious agents. Name an infectious agent of cats that may cause pericarditis
FIP
How can infectious pericarditis be treated?
Aggressive antibiotic therapy - culture
+/- exploratory thoracotomy and pericardectomy
