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SAM 1 > Pericardial Disorders and Cardiac Neoplasia > Flashcards

Pericardial Disorders and Cardiac Neoplasia Flashcards

1
Q

what is the most common pericardial disorder in dogs and cats?

A

pericardial effusion (dogs>cats)

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2
Q

usually what type of fluid is pericardial effusion in dogs?

A

sanguineous (hemorrhagic)

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3
Q

T/F: as long as IPP

A

TRUE, intrapericardial pressure needs to be lower so it doesn’t limit the heart’s ability to relax

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4
Q

what allows the parietal pericardium sac to stretch over time to accommodate increasing volume?

A

fibrous/fibroelastic properties

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5
Q

what is cardiac tamponade?

A

when IPP equals or exceeds ICP, diastolic filling decreases

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6
Q

what is a consequence of cardiac tamponade?

A

increase in systemic venous pressure (especially on right side) > congestion and effusion

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7
Q

do dogs or cats more commonly develop tamponade and therefore require pericardiocentesis?

A

dogs

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8
Q

what is the typical signalment of dogs with pericardial effusion?

A

middle-age to older, large & medium breeds (golden retriever, GSD, labs, brachycephalics), males

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9
Q

how do dogs with acute pericardial effusion commonly present?

A

collapse or weakness

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10
Q

what symptom in a dog with pericardial effusion may occur within 24-48 hours of presentation?

A

vomiting (GIT ischemia and hypoperfusion due to hearts inability to relax and fill with the proper amount of blood)

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11
Q

are heart sounds increased or decreased in intensity in a dog with pericardial effusion?

A

decreased “muffled”

also can be attributed to mod-severe pleural effusion

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12
Q

what test can confirm your diagnosis of pericardial effusion?

A

thoracic FAST

see RA collapse in cardiac tamponade, pleural and peritoneal effusions

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13
Q

buddy the golden retriever comes in and you suspect pericardial effusion. after doing a quick thoracic FAST you see he also has cardiac tamponade despite kissing and tail wagging. what now?!

A

THIS IS AN EMERGENCY!! perform a pericardiocentesis ASAP

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14
Q

your ultrasound machine is down and you have suspect a dog has pericardial effusion. you decide to take radiographs instead, what might you see?

A

markedly enlarged and globoid cardiac silhouette

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15
Q

what is causing the beat-to-beat variation in QRS amplitude you may see in a dog with pericardial effusion?

A

the heart is swinging back and forth in effusion (see tall R, then short, then tall, etc)

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16
Q

why are diuretics contraindicated in patients with pericardial effusion?

A

preload is keeping them alive! heart is already not filling with the proper amount of blood due to high intrapericardial pressure. diuretics will cause the body to excrete more water > therefore less volume > decreased CO and arterial hypotension

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17
Q

T/F: you should perform a coagulation profile prior to pericardiocentesis

A

TRUE, UNLESS patient isn’t stable. hemorrhagic effusion can also be from coagulopathy (i.e. rodenticide)

18
Q

what is the most common cause of pericardial effusion in dogs?

A

neoplasia (HSA)

19
Q

in what location is HSA most common?

A

right atrium/auricle

20
Q

where are HSA more likely to metastasize?

A

lungs and spleen

21
Q

T/F: prognosis is poor post pericardiectomy

A

not necessarily, don’t need the sac to live!

22
Q

in addition to chemotherapy (doxorubicin) and surgical resection as potential options for treatment of HSA, what other treatments might you consider?

A

*discourage bleeding!

yunnan baiyao = chinese herb w/ prothrombotic properties

aminocaproic acid = antifibrinolytic

repeated pericardiocentesis

23
Q

where do chemodectomas originate?

A

from chemoreceptor cells in ascending aorta (or carotid body)

24
Q

T/F: HSA are slow-growing tumors that are often large and locally extensive before onset of clinical signs

A

FALSE, chemodectomas

25
Q

in what breed are chemodectomas more common?

A

brachycephalics

26
Q

what signs might you see in a patient with chemodectoma?

A

exercise intolerance, syncope, dyspnea, cough, ascites

27
Q

what is the recommended procedure in increasing MST in patients with chemodectomas?

A

pericardiectomy

28
Q

what cardiac neoplasm can mimic idiopathic pericarditis?

A

mesothelioma (discrete mass)

29
Q

what cardiac neoplasia usually doesn’t have a mass and can be diagnosed through cytology of pericardial fluid?

A

lymphoma

30
Q

T/F: arrhythmias can be a potential complication of any cardiac tumor

A

TRUE

31
Q

what is the second most common cause of hemorrhagic pericardial effusion in dogs?

A

idiopathic pericarditis

32
Q

T/F: idiopathic pericarditis accumulates slowly, therefore you must move quick to perform an emergency pericardiocentesis

A

FALSE, accumulates SLOWLY

resolves in 50% dogs after initial pericardiocentesis

33
Q

what is the treatment of choice for recurrent pericardial effusion?

A

subtotal pericardiectomy

34
Q

what is a potential sequela of chronic pericardial effusion in a dog with idiopathic pericarditis?

A

constrictive pericarditis (parietal and/or visceral pericardium becomes fibrotic > limits diastolic filling > increased systemic venous pressure > +/- R-CHF)

35
Q

chronic inflammation, fungal infection, and idiopathic are all causes of what condition?

A

constrictive pericarditis

36
Q

what is the treatment of choice for constrictive pericarditis?

A

subtotal pericardiectomy +/- epicardial stripping

idiopathic?? +/- corticosteroids

37
Q

what is the most common cause of pericardial effusion in cats?

A

CHF

38
Q

what is the second most common cause of pericardial effusion in cats?

A

neoplasia

39
Q

T/F: peritoneopericardial diaphragmatic hernia (PPDH) is a congenital pericardial disease

A

TRUE

=abnormal development of septum transversum or pleuroperitoneal folds

40
Q

what breeds are predisposed to PPDH?

A

maine coon, domestic long hair, persian, weimaraner

41
Q

what are the most common herniated organs in PPDH?

A

liver and gall bladder (GI, spleen, omentum also possible)

42
Q

what test is diagnostic of PPDH?

A

thoracic radiographs (echo confirms)

SAM 1 (19 decks)

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