Small animal cardiology Flashcards
What is orthopnoea
Change in breathing related to position i.e shortness of breath when lying down
What is a cough from heart disease like compared to primary respiratory disease
Heart disease cough is softer and moister (due to some pulmonary oedema)
What is cyanosis
Blue/grey discolouration of mucous membranes due to increased quantity of deoxygenated Hb
i.e pA O2 <40mmHg, arterial saturation <70%
What does a more distended jugular vein indicate
Increased systemic venous pressure i.e higher right ventricular pressure
What type of heart failure is ascites a sign of
Right sided
Because increased pressure in right side of heart so impairment of pumping blood to the lungs
WHen might we have a decreased pulse pressure
Heart failure
Hypovolvaemia
When might we have an increased pulse pressure
Anaemia
Patent ductus arteriosus
Aortic regurgitation
What is a pulse deficit
Where a heart beat does not generate a palpable pulse e.g in some tacharrhythmias
What is the precordial impulse
Apex beat
Usually found at LIC4/5
What is the diaphragm used for hearing
High frequency sounds
What is the bell used for (stethoscope)
Low frequency sounds e.g 3rd and 4th heart sounds in a dog
What valve does the L apex beat correspond to
Mitral valve
= first heart sound
What do we hear at the base beat
Aortic and pulmonic valves; hard to differentiate them on small dogs and cats
Where do we hear the tricuspid valve
Right heart apex
When might the second heart sound be split
Pulmonary hypertension
= because high pressure in pulmonary veins means delayed closure of pulmonary valve so separated in time from closure of the aortic valve
Which heart sound becomes very dominant in stress/exercise
First heart sound (AV valve closure)
Because it is dependent on ventricular contractility
What is the third heart sound and when might we hear it
Noise from rapid ventricular filling during diastole
- get noise where there is vibration in a stiffer than normal ventricular wall e.g if it hasn’t emptied fully such as dilated cardiac myopathy
What is the fourth heart sound and when might we hear it
Occurs in atrial systole when blood is forced into an over distended ventricle e.g in feline hypertrophic cardiac myopathy
When can it be hard to distinguish extra heart sounds
In high heart rates e.g cats with HR>180
What are the two mechanisms of heart murmurs
Turbulence of blood flow
Vibration of a cardiac structure
What causes flow murmurs
Low viscosity blood
e.g in immature animals, anaemia
+ increased cardiac outflow velocity can cause it
Murmur grading system
I - heard in a quiet room
II – faint but easily heard; disseminated over larger area e.g on both sides
III – same intensity as heart sounds
IV – louder than the heart sounds
V – loud murmur plus palpable thrill
VI – heard when stethoscope removed from the chest wall
What is the loudest and most common type of murmur
Systolic
What are the systolic murmurs
AV valve regurgitation
Left to right shunting in a ventricular septal defect
Aortic stenosis
Pulmonic stenosis