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52 Cards in this Set

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What are the functions of the pericardium?
Lubrication
Stabilization
Infection barrier
T or F:
PPDH is usually due to traumatic injury.
False!
it is ALWAYS a congenital defect
What organs are generally found in a PPDH? When is it an emergency? What breed is predisposed?
Liver and omentum
If stomach is in there, EMERGENCY;
Weimaraners are predisposed
Which pericardial congenital defect always requires surgery?
a) pericardial cysts
b) PPDH
c) pericardial defects
d) none of the above!
a) pericardial cysts (they trap stuff and compress the heart)
Constrictive pericarditis in small animals is generally due to..
...coccidiodomycosis
What is the breakdown of pericardial effusions in terms of cause?
75% neoplastic
20% idiopathic
5% other
What are the common tumors involving the pericardium?
Hemangioma/sarcoma
Mesothilioma
Heartbase tumors (chemodectoma; ectopic thyroid/parathyroid)
T or F:
Whenever you find HSA on the spleen, there is a 25% chance of mets to the right atrium/auricle.
False!
The heart HSA is CONCURRENT, PRIMARY AND NOT METASTATIC
Chemodectomas are usually found in which breeds?
Brachycephalicq
If you find a pericardial effusion but cannot find any tumors, what is your next step?
TAP THAT BITCH! Pericardiocentesis is generally curable in idiopathic causes!
What are the 3 cardinal signs of pericardial effusion (Beck's Triad)?
Muffled heart sounds
Venous congestion/Jugular pulses
Weak femoral pulses
Describe the pathogenesis of cardiac tamponade.
Pericardial vol/pressure increase, thus reducing compliance (esp in R heart); SV declines which activates RAAS; HR increases and CO reduces
What two things will be seen on a radiograph of cardiac tamponade?
Globoid heart
enlarged CVC
How do you perform a pericardiocentesis? How often is it curative?
Clean/perp per usual
Tap on the right side and aim for the center of the heart!
(50% of the time it works all of the time)
When performing a subtotal pericardiectomy, what structure should you leave intact?
The heart! Oh yeah, and the phrenic nerves...
What are causes of pericardial effusion in cats?
Cardiomyopathy
LSA
FIP
What are the three main classes of congenital heart disease in dogs?
Acyanotic with no shunt
Acyanotic with L to R shunt
Cyanotic with R to L shunt
Which of the following are NOT acyanotic L to R shunts?
a) PDA
b) Tetralogy of Fallatio
c) VSD
d) ASD
e) subaortic stenosis
a) PDA (can SOMETIMES be cyanotic R to L with pulmonary hypertension)
b) Tetralogy of Fallot is a R to L cyanotic shunt
What are the top 4 congenital heart defects in dogs?
1. PDA
2. Subvalvular aortic stenosis
3. Valvular pulmonic stenosis
4. VSD
Predict patterns of enlargement in...
...PDA
Enlarged pulmonary vasculature
Enlarged aortic arch proximally
Enlarged LA and LV
Predict patterns of enlargement in...
...VSD
LV enlargement
Pulmonary vasculature
(maybe RV eccentric enlargement)
Predict patterns of enlargement in...
...ASD
RA
RV
Pulmonary vasculature
T or F:
PDA has female predisposition in dogs.
TURD!

um that was supposed to say true
What is the pathogenesis of PDA?
a) lack of maternal signaling to the ductus
b) lack of placental signaling to the ductus
c) lack of ductus recognition of increased oxygen tension
d) congenital reduction in ductus smooth muscle
e) all of the above
d) congenital reduction in ductus smooth muscle (can't constrict)
How will a PDA commonly present?
Young animal, continuous murmur, bounding femoral pulse
What other congenital anomaly is commonly associated with PDA?
Persistent Left Cranial Vena Cava
What drug needs to be given perioperatively during a PDA surgical correction?
Dobutamine (keeps the heart pumpin' strong)
How does a R to L PDA present?
Lame, split S2, differential cyanosis
R heart enlargement (reverse D)
How are R to L PDAs corrected?
NOT SURGICALLY CORRECTED - BLEED THEM WITH LEEECHES!!!
Medical management with hydroxyurea to prevent polycythemia
T or F:
The RV is NOT enlarged in a VSD.
False! This describes the Right Atrium!
How are VSDs diagnosed?
Echo is the best!
Rads also help...
PE should find the murmur on the RIGHT
ECG is pretty worthless
VSD murmurs are loudest on the __________ side (just like ______________ murmurs).
loudest on the RIGHT (like tricuspid insufficiency)
How are VSDs managed?
most require no intervention; big ones might be surgically treated by banding the pulmonary artery (mild stenosis to decrease the severity of the shunt)
How are ASDs diagnosed?
ECG shows R heart enlargement
Rads show R heart enlargement
PE finds ejection murmur at heart base
Echo finds the defect!
What is the most common cyanosis producing defect?
Tetralogy of Fallot
What are the 2 things necessary in producing a R to L shunt?
Hole from R to L
Something elevating pressures on the R
What are clinical signs of R to L shunts?
Cyanosis
Polycythemia
Low PaO2
Small pulmonary vasculature (on rads)
What is the most sensitive test for R to L shunt?
Contrast echocardiograph
What 4 thingys comprise the Tetralogy of Fallot?
Pulmonic stenosis
VSD
Dextropositioned Aorta
RV hypertrophy
What are physical exam findings in at Tetralogy of Fallot?
Systolic murmur @ left heart base
Normal arterial pule
Cyanotic at rest or with exercise
How can Tetralogy of Fallot be treated?
Pretty much like a R to L PDA - treat the polycythemia w/hydroxyurea
What are the major secondary changes in subvalvular aortic stenosis?
LV hypertrophy (concentric)
Post stenotic dilation of aorta
What would physical exam findings be in a dog with subvalvular aortic stenosis?
Diamond shaped ejection murmur at left heart base
Weak femoral pulse
If abnormal, what are some possible ECG findings in subvalvular aortic stenosis?
Tall R waves w/wide QRS
ST depression/elevation
Which are appropriate treatments for significant subvalvular aortic stenosis in dogs?
a) Exercise restriction
b) Beta blockade
c) balloon valvuloplasty
d) digoxin
a) Exercise restriction
b) Beta blockade
(note: valvuloplasty does work but it tends to re-stenose)
Where does pulmonic stenosis typically occur?
a) subvalvular
b) valvular
c) supravalvular
d) wherever it friggin' wants to!
b) valvular
Valvular>subvalvular>supravalvular
When performing cardiac auscultation in puppies, where should you spend a lot of time and why? In old dogs?
Puppies (left base d/t pulmonic and aortic stenosis, PDA)
Old dogs (base d/t AV degeneration)
What heart defect do 20-25% of dogs with pulmonic stenosis have?
Tricuspid insufficiency
In which breeds is pulmonic stenosis more commonly seen?
Terriers, Schnauzers, Bulldogs
What abnormality is commonly concurrent with pulmonic stenosis in bulldogs and why is this bad?
aberrant left coronary; it can pop with balloon valvuloplasty
What dictates treatment with pulmonic stenosis?
Pressure gradient over the stenotic region.
If >80-85 definitely treat. If <50 not treatment. If between the two, maybe treat.
How is pulmonic stenosis treated?
Most (valvular) treated with balloon valvuloplasty