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Small Animal Medicine > Systolic Dysfunction > Flashcards

Systolic Dysfunction Flashcards

Exam IV

1
Q

Three main functions

A 
Conduct electricity (rhythms; know the PQRST waves) - does not mean contraction
Myocytes conduct electricity

Systole (contraction)

Diastole (filling)

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2
Q

How does blood flow?

Know chambers

A

From high pressure to low pressure

Systemic venous: 5
RA: 5
RV: 20/5
PA: 20/8
PCap: 6
PV: 6
LA: 6
LV: 120/6
Ao: 120/80
Systolic/Diastolic 
Diastolic = low for filling
Systolic = high for pushing blood out
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3
Q

Blood pressure equation

A

BP = CO x Systemic Vascular Resistance

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4
Q

Concentric hypertrophy
What is it?
What DfDx?

A

Wall thickening and lumen gets smaller

Diastolic dysfunction
Pressure overload
HCM

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5
Q

Eccentric hypertrophy
What is it?
What DfDx?

A

Wall is the same size but there is an increase in the lumen size

Systolic dysfunction (residual blood in lumen) 
Volume overload
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6
Q

Sequela to systolic dysfunction

A

As lumen gets bigger the mitral valve gets pulled apart -> murmur

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7
Q

Systolic Dysfunction

Murmur

A

Murmur:
Left side; Mitral valve
Timing: systolic
Quality: regurgitation/plateau

Endocardiosis can cause this

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8
Q

Systolic Dysfunction

Femoral Pulses

A

Potentially weak

Lower CO so not as strong of pulses as normal (LV not contracting properly)

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9
Q

Systolic Dysfunction

PE findings

A

Arrhythmias; pulse deficits

Hear beat but do not feel pulse

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10
Q

Systolic Dysfunction

DfDx (two categories)

A

Primary:
DCM (diagnosis of exclusion)
Arrhythmogenic Right Ventricular Cardiomyopathy

Secondary:
Toxin/Drug (Doxorubicin)
Dietary deficiency
Tachycardia-induced cardiomyopathy
Hypothyroidism
Inflammation (Myocarditis; sepsis)
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11
Q

Systolic Dysfunction

Treatment

A

Treat underlying disease!

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12
Q

Systolic Dysfunction:
Hypothyroidism
Physiologic effects
Treatment

A

Physiologic effects of thyroid hormone:

Indirect cardiac effects -> increase metabolic rate; heart is responsible for delivering oxygen to body

Direct cardiac effects -> increases iontropy + chronotropy
Direct receptors on heart

Treat hypothyroidism (levothyroxine) and may cause systolic dysfunction to resolve

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13
Q

Systolic Dysfunction:
Tachycardia-Induced Cardiomyopathy
Arrhytmia?
Treatment?

A

Supraventricular arrhythmias
Atrial fibrillation

Treatment:
Stop the tachycardia
Antiarrhythmic (beta-blocker, sotalol, diltiazem, digoxin)
Catch early enough you can cure it

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14
Q 
Systolic Dysfunction:
Dietary Deficiency (Taurine)
A

Taurine!
Amino acid (concentrated in the heart and retina)
An essential amino acid in cats (b/c cannot make their own)

Causes:
Central retinal degeneration (blindness)
Cardiac systolid dysfunction

Grain free diets are causing this!

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15
Q

Systolic Dysfunction:
Dietary Deficiency
Treatment

A

Treat CHF:
Furosemide
Pimobedan
ACE-inhibitor

Taurine or L-carnitine supplementation

Potential diet change

Potentially curable if caught early enough

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16
Q 
Systolic Dysfunction:
Dietary Deficiency (L-carnitine)
A

Protein:
Concentrated in skeletal and cardiac muscles

Who?
American Cocker Spaniels
Golden Retrievers
Boxers

17
Q

Systolic Dysfunction:

Doxorubicin

A

Chemotherapeutic agent
Free radical that damages organs that use a lot of oxygen

Cardio toxic:
Dose dependent
Arrhythmias
Severe systolic dysfunction

Prognosis:
Poor because irreversible

18
Q

Systolic Dysfunction:

Primary DCM Treatment

A

Stage B (pre-CHF):
B1: monitor
B2: Pimobendan, +/- ACE inhibitor

Stage C (post-CHF):
Furosemide, Pimobendan, ACE-inhibitor, +/- spironolactone, +/- antiarrhythmics
Not a good prognosis overall

CHF?
Fluid in the lungs is possible! (pulmonary edema)

19
Q

Systolic Dysfunction:
Arrhythmogenic Right Ventricular Cardiomyopathy
What is it?

A

Boxer Cardiomyopathy

Unique disease; right-sided disease that can cause syncope and/or sudden death

Idiopathic most likely genetic component

Histologically: fibro-fatty replacement of myocytes

20
Q

Systolic Dysfunction:
Arrhythmogenic Right Ventricular Cardiomyopathy
Diagnosis

A

Holter monitor for 24 hours looking for VPCs

Echocardiogram

21
Q

Systolic Dysfunction:
Arrhythmogenic Right Ventricular Cardiomyopathy
Treatment

A

Arrhythmias:
Antiarrhythmics (Mexiletine, Sotalol)

Systolic Dysfunction:
CHF -> furosemide, Pimobendan, ACE-inhibitor, +/- spironolactone

Small Animal Medicine (8 decks)

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