Pericarditis, Myocarditis, Vasculitis

Question 1

Pericarditis clinical signs include __, +/- __ with muffled __ sounds or __ with dull __ sounds and cardiac __

Answer 1

Pericarditis clinical signs include lethargy, +/- fever with muffled heart sounds or friction rubs with dull ventral lung sounds and cardiac tamponade

Question 2

What is the best diagnostic for pericarditis?

Answer 2

Ultrasound

Question 3

What are the 3 types of pericarditis?

Answer 3

1. Effusive: characterized by fluid accumulation
2. Fibrinous: fluid + fibrin in the pericardium
3. Constrictive : fibrous tissue of the pericardium/myocardium results in compression of the heart, permanently impairing diastolic filling

Question 4

Pericardiocentesis: idiopathic, bacterial, neoplastic fluid

Answer 4

1. Idiopathic: variable nucleated cell count, increased protein and non degenerate neutrophils
2. Bacterial: high TNCC, primarily degenerate neutrophils, +/- bacteria
3. Neoplastic: variable nucleated cell count and protein +/- neoplastic cells

Question 5

Treatment of pericarditis

Answer 5

• Pericardiocentesis with ECG telemetry and simultaneous fluid administration
• broad spectrum antimicrobial therapy (K pen and gentamicin)
• consider fibrinoloytics or anti coagulants
• corticosteroids for non specific pericarditis

Question 6

Myocarditis is inflammation of the cardiac muscle that causes __ and decreased __ and __

Answer 6

Myocarditis is inflammation of the cardiac muscle that causes arrhythmias and decreased SV and CO

Question 7

Myocarditis can be from nutritional myodegeneration which is typically a result of __ deficiency.

Answer 7

Myocarditis can be from nutritional myodegeneration which is typically a result of selenium/Vitamin E deficiency.

Question 8

Clinical signs of myocarditis

Answer 8

Lethargy, syncope, low grade colic, tachycardia, bradycardia

Question 9

Diagnostics for myocarditis

Answer 9

CBC + serum chemistry/vBG
Cardiac troponin I
ECG + echocardiogram (fractional shortening)

Question 10

What’s the main treatment of myocarditis and prognosis

Answer 10

Gastric lavage and charcoal

Prognosis depends of the cause and response to treatment. Fractional shortening that persists at <20% likely indicates poor prognosis

Question 11

Aortic rupture is most common in __ horses and has clinical signs of __,__, __, and __.

Answer 11

Aortic rupture is most common in older horses and has clinical signs of peracute ,colic , tachycardia, and continuous murmur.

Question 12

Vasculitis clinical signs

Answer 12

Edema, petechia and ecchymoses if complicated by thrombocytopenia, organ specific dysfunction

Question 13

What are some cause of infectious vasculitis

Answer 13

Rickettsial organisms, EHV, EEE, etc.

Question 14

How does immune mediated vasculitis occur?

Answer 14

Deposition of immune complexes on blood vessel walls results in complement mediated destruction.
-> Strep equi > 1:1600

Question 15

Purpura hemorrhagica

Answer 15

Immune mediated vasculitis leading to extensive edema and hemorrhage of the mucosa and subcutaneous tissue

Question 16

Diagnostics for vasculitis

Answer 16

Buffy coat smear + whole blood PCR for anaplasma phagocytophilum, nasal swab PCR for viral disease, S. equi M protein ELISA for antibodies, consider biopsy for definitive diagnosis

Question 17

Treatment for vasculitis

Answer 17

Rickettsial organisms: oxytetracycline
PH: steroids, consider other immune suppressing drugs
Anti inflammatory: NSAIDs, pentocxyfylline
Careful fluid therapy: consider plasma