Q1 Exam 1 Flashcards
what does a differential cyanosis in puppies signify
reverse PDA
pulse pressure
difference between systolic and diastolic pressures
2 causes of pulse deficits
a fib and PVCs
pulsus paradoxus
reduced pulse pressure during inspiration (normal) but can be exaggerated with cardiac tamponade
murmur grading scale
1- less than normal heart sounds
2- heart sounds louder still, but clearly there
3- radiates to both sides of chest
4- no normal heart sounds heard
5- palpable thrill
6- heard off of chest
AV valve murmurs
heard at apex, plateau-shaped systolic (also DCM)
semilunar valve murmurs
ejection murmur at heart base (VSD and HCM also)
diastolic murmurs
PDA, semilunar regurg, mitral stenosis
in canine cardiac disease, when is there respiratory effort?
inspiration
what can a long or tall p-wave signify on ECG
long = LAE
tall = RAE
normal QRS duration
dog = 0.06s
cat = 0.04s
supraventricular
originates above the bundle of his
wandering pacemaker
p-wave gets taller during faster heart rates (vagal)
sinus bradycardia
parasympathetic, give atropine
sick sinus syndrome
fast heart rates then nothing, causes syncope in mini schnauzer, needs pacemaker
causes of atrial standstill
hyperkalemia, atrial myopathy, artifact
first degree AV block
prolonged PR (no dropped beats)
second degree AV block type I
PR prolongs and then dropped beat, tx atropine challenge
second degree AV block type II
PR constant, atropine challenge
third degree AV block
complete dissociation, needs pacemaker
APCs
LAE maybe, non-compensatory pause (HR finds new rhythm)
a fib
fast irregular rhythm with narrow QRS, no p waves
VPCs
premature wide QRS with compensatory pause, tx holter
wide complexes origin (left or right)
positive = right
negative = left
accelerated idioventricular rhythm
AV dissociation (consecutive VPCs) while HR under 160
ventricular tachycardia
wide QRS with complete AV dissociation, HR more than 160, hemodynamically unstable! convert with lidocaine
v fib
crazy rhythm, needs defibrillation
abnormal VHS
dog 10.2
cat 7.8
VLAS
more than 2.3 LAE and more than 3 needs vetmedin
heart failure stages
A- predisposed
B1- murmur, only LV dilation OR LAE, slightly enlarged heart
B2- murmur, enlarged heart tx with pimobendan if murmur >3/6
C- congestive heart failure tx pimobendan, ACE-i and furosemide
what can confound a BNP test
cleared through kidneys, CKD
what drug is an inodilator
pimobendan (increases cAMP and intracellular calcium)
which ACE inhibitor is almost all cleared through kidneys
enalapril
restrictive cardiomyopathy in cats
atrial enlargement but normal ventricles
ARVC in cats
RV and/or RA dilation due to fibrofatty replacement of myocardium, causes arrhythmias (tricuspid regurg common)
secondary causes of LV hypertrophy in cats
systemic hypertension (CKD) and hyperthyroid
tx for thromboembolism in cats
clopidogrel (LAE)
reverse PDA
no murmur, differential cyanosis, high HCT, right sided CHF poor prognosis
aberrant coronary
English bulldogs causes pulmonary stenosis
chronotropy
heart rate
lusitropy
myocardial relaxation
dromotropy
conduction speed
bathmotropy
degree of excitability
what does the endothelial glcyocalyx affect in the fluid movement model
oncotic pressure
examples of distributive shock (3)
sepsis, anaphylaxis, and excessive catecholamines
examples of obstructive shock (4)
GDV, obstruction of vena cava, tension pneumo, and pericardial tamponade
what percent of dehydration causes hemodynamic changes?
10-12%
shock index
HR/SBP, should be less than 0.9
what signifies decompensatory shock
poor pulses, pale membranes, drop in BP
what type of shock are vasopressors particularly useful
distributive
1/4 shock dose fluid bolus
10-20 ml/kg over15 to 30 minutes
ROSE
resuscitation, optimization, stabilization, evacuation
fresh frozen plasma
natural colloid
hypotensive resuscitation
temporary endpoint of lower than normal SBP
acepro
blocks a1, vasodilation, antiarrhythmic effect
benzos
affects CNS not CV
a2-agonists
depresses CV, increases SVR
opioids
minimal effects on CV, dose dependent increase in HR
DOC for induction of cardio patients
etomidate (zero CV effects) but adrenal supression
alfaxalone
short period of apnea, transient decrease in arterial BP
ketamine
indirect CV stimulant bc sympathetic tone high (not in HCM or mitral regurg, but YES in DCM and cardiogenic shock)