Sporadic Sick Cow: Cardiac Diseases

Question 1

what does a clinical exam entail (7)

Answer 1

1. thoracic: pain-whither test/abducted elbows/stance
2. edema: submandibular, presternal, ventral
3. mucous membrane colour: pale/cyanosis
4. jugular distension, pulsation or positive refill test
5. exercise intolerance
6. increased HR, arrhythmias
7. non-specific signs too: pyrexia, other disease processes

Question 2

what is right side backward failure

Answer 2

backs up into circulation

Question 3

what is right side forward failure

Answer 3

limitation on blood being pumped to the lungs similar signs to L side forward failure

Question 4

what is left sided backward failure

Answer 4

backs up into lungs which will tend to produce respiratory failure

Question 5

what is left sided forward failure

Answer 5

low BP

fainting

Question 6

what are the signs with right congestive/backward heart failure (4)

Answer 6

1. jugular signs
2. systemic edema
3. nutmeg liver
4. pale tense kidneys

Question 7

what are the signs of left sided congestive/backward heart failure

Answer 7

pulmonary edema (rare)

Question 8

what are the normal heart sounds in clinical exam

Answer 8

1. murmurs: especially when unwell (more common with heart rate)
2. gallop/split sound: 3rd and 4th sound

when unwell can heart a grade II aortic murmur –> no clinical significance

Question 9

what are abnormal heart sounds on clinical exam (5)

Answer 9

1. murmur
2. splash/tinkle (muffled and then splash sound)
3. no heart sound (!!!)
4. sinus arrhythmia (BSE)
5. palpable thrill

Question 10

what causes netmeg liver

Answer 10

chronic venous congestion

Question 11

what pathology is shown

Answer 11

pale tense kidney

rounded borders

Question 12

what are the causes of traumatic pericarditis

Answer 12

traumatic penetration of wire from the reticulum

Question 13

what is the history traumatic pericarditis

Answer 13

recent calving

tires in silage pit

Question 14

what are the clinical signs of traumatic pericarditis (6)

Answer 14

1. muffled heart
2. splashing
3. pyrexia: infected process
4. CV signs
5. withers positive/thoracic pain
6. non-specific signs: abducted elbows, rumninal contractions will have pause, local peritonitis, gas produced swishing sound of heart

Question 15

how is traumatic pericarditis diagnosed (5)

Answer 15

1. CS
2. +/- ultrasound (fluid in pericardial sac)
3. neutrophilia + increased globulins
4. reduction in PCV
5. leakage of liver enzymes (nutmeg liver)

Question 16

how is traumatic pericarditis treated

Answer 16

1. rarely successful
2. broad spectrum antibiotics –> rumenotomy (guddle for the wire)
3. magnet

Question 17

how is traumatic pericarditis prevented

Answer 17

prophylactic magnets

metal detector on forage harvester

Question 18

what is shown here

Answer 18

traumatic pericarditis

Question 19

what causes endocarditis

Answer 19

bacteria from bacteremia or septicemia settle on valve leaflets causing granulomatous infection

tricuspid valve most common but can be mitral

may have history of past infection (metritis, sore foot, myasis in sheep)

secondary septic infarcts –> pulmonary or systemic

Question 20

what are the clinical signs of endocarditis (5)

Answer 20

1. murmur (variable)
2. pyrexia (initally/intermittent)
3. cardiovascular signs (right side congestive)
4. abduction of elbows (thoracic pain)
5. +/- whithers positive

Question 21

how is endocarditis diagnosed

Answer 21

clinical exam (ultrasound scan)

Question 22

how is endocarditis diagnosed with bloods

Answer 22

increased globulin

neutrophilia

Question 23

how is endocarditis treated

Answer 23

rarely successful

borad spectrum antibiotics + NSAIDs

Question 24

how is endocarditis prevented

Answer 24

prevent immunosuppression and primary illness with prompt

aggressive tx of any infections

Question 25

what pathology is this

Answer 25

endocarditis vegetative lesion on right side of the heart

Question 26

what pathology is shown here

Answer 26

vegetations forming on the heart valves

Question 27

what is high altitude or brisket disease

Answer 27

common above 2500m age, pregnancy

Question 28

what are the predispositions of high altitude or brisket disease (5)

Answer 28

1. cold weather 2. rapid weight gain 3. intercurrent pulmonary diseases 4. exposure to endotoxins, swainsonine, monocrotaline, ionophores 5. beef

Question 29

what is the most common congenital heart disease

Answer 29

ventricle septal defect

Question 30

what are the clinical signs of VSD (4)

Answer 30

1. systolic murmur (PMI right) 2. +/- systolic 3. +/- CV signs 4. +/- exercise intolerance

Question 31

how is VSD diagnosed (4)

Answer 31

1. diagonal murmur 2. caudal LHS 3. cranial RHS 4. colour flow doppler: lesion is difficult to find with 2D ultrasound

Question 32

how is VSD treated

Answer 32

none

Question 33

what is the prognosis of VSD

Answer 33

can be okay

Question 34

what pathology is shown here

Answer 34

ventricular septal defect --\> hole in heart in the right ventricle: greatly enlarged and thickened ventricle depends on the size of the VSD and whether RV pressure is elevated or not

Question 35

what is ASD

Answer 35

atrial septal defect persistent foramen ovale

Question 36

what are the signs of ASD

Answer 36

usually no signs no murmur left to right shunt (relative pressures)

Question 37

what is PDA

Answer 37

patent ductus arteriosus

Question 38

what causes PDA

Answer 38

ductus arteriosus bypassess lungs in fetus (RHS heart straight to aorta normal function) closes in first few hours/days of life continuous machinery murmur far forward RHS of chest, often also a LHS heart base murmur

Question 39

which is more common VSD or PDA

Answer 39

VSD

Question 40

how is PDA inherited

Answer 40

polygenic threshold trait

Question 41

what is tetralogy of fallot

Answer 41

1. VSD 2. pulmonic stenosis 3. dextroposed aorta: overrides the VSD 4. then secondary right ventricular hypertrophy

Question 42

what are the clinical signs of tetralogy of fallot (4)

Answer 42

1. murmur 2. stunting 3. CV failure 4. cyanosis

Question 43

how is tetralogy of fallot treated

Answer 43

none

Question 44

what is the prognosis of tetralogy of fallot

Answer 44

most die

Question 45

what are cardiomyopathies caused by (4)

Answer 45

1. selenium/copper/cobalt deficiency 2. DCM genetic in: Holstein, Hereford, Red Danish, Japanese Black 3. viral disease in young lambs 4. toxins

Question 46

what is the normal heart rhythm in bovines and ovines

Answer 46

regularly regular rhythm (at a clinical level though relaxed sheep will have a sinus arrhythmia)

Question 47

do primary arrhythmias cause disease

Answer 47

not usually

Question 48

what are causes of secondary arrhythmias (5)

Answer 48

1. hypocalcemia 2. hypomagnesemia 3. endotoxin 4. intestinal disease (acid/base imbalance) 5. abdominal pain

Question 49

what is the most significant arrhythmia

Answer 49

atrial fibrillation