Pericardial Disease and Endocarditis (Borgarelli)

Question 1

Signalment for pericardial effusion

Answer 1

Older, large-breed dogs (golden retrivers, labradors, german shepherds)

Question 2

Pathogenesis of cardiac hemangiosarcoma

Answer 2

Cancer of blood vessels, most commonly RA and AV junction. Causes irregular blood vessels that spill into pericardium and compress the heart/reduce CO (cardiac tamponade)

Hemangiosarcoma can develop in many different parts of the body, with common sites including the skin, muscle, spleen, liver and heart

Question 3

What are the 3 types of neoplasia causing 75% of pericardial effusion canine cases?

Answer 3

1. Hemangiosarcoma
2. Heart-base tumors (Chemodectomas and thyroid/parathyroid adenoma/carcinomas)
3. Mesothelioma

Question 4

Chemodectoma and tx/prognosis

Answer 4

Tumor of chemoreceptor cells, typically on aorta or carotid aa.

• tx = pericardectomy (tumor removal + part of pericardial sac)
• prognosis: improved recovery + live significantly longer

Question 5

Etiology/pathogenesis of cardiac mesotheliomas

Answer 5

• mesodermal origin (mesothelial cells line pericardial, pleural and peritoneal cavities),
• cause pericardial effusion -> cardiac tamponade

Question 6

How does pericardial effusion lead to cardiac tamponade?

Answer 6

When such high pressure in the pericardium leads to increased ventricular pressure + impaired filling -> decreased CO

When pressure in pericardial sac = pressure in ventricle

Question 7

Beck’s Triad

Answer 7

PE findings for pericardial effsion / cardiac tamponade:

Question 8

Pulsus Paradoxus

Answer 8

NORMAL: systolic BP slightly decreases during inspiration (not noticeable femoral pulse strength)

PERICARDIAL EFFUSION/CARDIAC TAMPONADE: an exaggerated drop of inspiratory systolic BP occurs (due to increased pressures of pericardium/chambers) -> NOTICEABLY DECR. / ABSENT FEMORAL PULSE STRENGTH

Question 9

ECG finding of PE + C.TAMP

Answer 9

Sinus tachycardia

decr. SV + incr. HR = decr. CO

Question 10

Why are diuretics contrainidicated in patients with pericardial effusion?

Answer 10

It will only further decreased pre-load -> patient will die

these patients already have low CO