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276 Cards in this Set
- Front
- Back
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what type of system is the cardiovascular system and what does this mean |
it is a closed system and this means if you affect one part it has an effect on another part |
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what is the cardiovascular system composed of |
-heart -blood -vessels |
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how many chambers are in the heart (of mammals) |
4 |
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what tool measures the electrical conduction of the heart |
the electrocardiograph (ECG) |
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arteries |
-transport blood away from the heart -usually oxygenated |
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veins |
-transport blood towards the heart -usually deoxygenated |
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what is the most commonly occurring cancer of the heart |
hemangiosarcoma |
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what are the clinical signs of hemangiosarcoma |
-intermittent weakness -pallor -anemia -sudden collapse -sudden death pericardial tamponade -hemoabdomen |
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how is hemagiosarcoma diagnosed |
-ultrasound -lab work -abdominocentesis -muffled heart sounds on auscultation |
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what is the prognosis for hemagiosarcoma |
grave |
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what are the treatment options for hemangiosarcoma |
-pericardial fenestration -spenectomy |
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what are the 3 forms of cardiomyopathy |
-dilated -restrictive -hypertrophic |
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what is a cardiomyopathy |
primary disease of the myocardium (muscle of the heart) |
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what happens to the muscle in dilated cardiomyopathy |
it thins |
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what happens to the muscle in restrictive cardiomyopathy |
-the muscle loses compliance -the muscle is replaced with fat or fibrotic tissue |
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what happens to the muscle in hypertrophic cardiomyopathy |
the muscle thickens |
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which species do cardiomyopathies affect |
dogs and cats |
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which breeds are predisposed to canine dilated cardiomyopath |
-large and giant breed dogs (particularly older animals) -young danes -old dobies -irish wolfhouds -cocker spaniels |
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what is the etiological agent of canine dilated cardiomyopathy |
unknown but believed to have a genetic component |
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why do cocker spaniels get canine dilated cardiomyopathy |
because of a taurine deficiency |
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ischemia |
decreased supply of oxygenated blood |
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what happens to chambers of the heart in dilated cardiomyopathy |
the muscles of the heart (especially the ventricles) expand |
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what happens to the chambers of the heart in hypertrophic cardiomyopathy |
-the chambers of the heart get smaller |
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what is the etiology of cardiomyopathies |
unknown |
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what is the most common cause of cardiac disease in large and giant breed dogs |
canine dilated cardiomyopathy |
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what is pericardial tamponade and which disease we discussed is it a symptom of |
-the accumulation of fluid on the inside of the pericardial sac, around the heart that interferes with its ability to beat -associated with hemangiosarcoma -occurs when a tumor in the right atria bleeds quickly and the pericardial sac cannot adjust accordingly |
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what may you see on labwork with hemangiosarcoma |
-changes in the morphology of red blood cells, especially in atrial hemangiosarcoma (may see lysis of red blood cells) -low red blood cell count -possible thrombocytopenia (the platelets are being used up to try to stop t he bleeding of the tumor) |
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what is pericardial fenestration and which disease we discussed is it a treatment for |
-making holes int he pericardial sac to prevent pericardial tamponade -makes an animal more comfortable and gives the animal a little more time (but not much) -used for hemangiosarcoma |
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what is the prognosis of hemangiosarcoma |
-grave (even with treatment) -if an owner opts for a splenectomy patient may get another 2-4 months post-surgery but prognosis is still poor due to the metastatic nature of the disease |
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which organs does hemangiosarcoma effect |
-heart (especially the right atrium) -spleen -skin/cutaneous form (the least metastatic of all 3) |
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what is the most common form of hemangiosarcoma |
tumor at the heart base, particularly the right atrium |
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which breeds and age groups are commonly affected by hemangiosarcoma |
-german shepherds -golden retrievers -ages 9+ -occasionally cats but less common
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what can bruising of the heart from a blunt force trauma to the chest cause? |
ventricular premature contractions |
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when do we see an onset of clinical signs of ventricular premature contractions/bruising of the heart due to a blunt force trauma |
24-48 hours |
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an animal is HBC but appears fine, what are we concerned about with the heart and when would we expect to see it occur |
-ventricular premature contraction from bruising of t he heart -24-48 hours after trauma |
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what is a grade I heart murmur |
-can be heard in a quiet room -requires little/no environmental noise to be heard |
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what is a grade II heart murmur |
-can be heard in a loud room |
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what is a grade III heart murmur |
-can be heard in a loud room -palpable in a peripheral pulse |
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what is a grade V heart murmur |
-murmur with palpable thrill (it can be felt when you put your hand on their chest) |
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what is a grade VI heart murmur |
-has visible precordial thrills (you can see it causing flutters on their chest) -can hear it walking in the room |
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what is a grade IV heart murmur |
a murmur that is visible in the pulse |
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an animal comes in with a heart murmur that can only be heard in a quiet room, which grade is it? |
grade I |
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an animal comes in with a heart murmur that can be heard in a loud room, which grade is it |
grade II |
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an animal comes in with a heart murmur that can be heard in a loud room and is palpable in the peripheral pulse, which grade is it |
grade III |
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an animal comes in with a heart murmur that is visible in the pulse, which grade is it |
grade IV |
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an animal comes in with a heart murmur that has a palpable thrill (you can feel it when you put your hands on their chest), which grade is it |
grade V |
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an animal comes in with a heart murmur that has visible precordial thrills (you can see it causing a flutter on the chest), which grade is it |
grade VI |
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in regards to heart murmurs, what is a palpable thrill |
you can feel the murmur when you put your hand on their chest |
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in regards to heart murmurs, what is a visible precordial thrill |
when you can see the murmur causing on a flutter on the chest, you can see the beat of the heart against the chest |
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what is the normal heart rate for dogs |
-70-160 bpm (smaller dogs tend to have a higher heart rate than larger |
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what is the normal heart rate for cats |
160-200 (240) bpm |
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vpc stands for |
ventricular premature contractions |
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what does ECG stand for |
elctrocardiograh |
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what is an electrocardiograph (ECG) |
-a measurement of the electrical conduction of the heart -makes sure the electrical conduction is normal through the heart |
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what is an echocardiogram |
-an ultrasound of the heart |
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what is a proBNP |
-an enzyme test -enzyme becomes elevated as the structure changes occur int he heart muscle |
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what is the best diagnostic tool for evaluating the lungs |
x-ray |
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what is the best diagnostic tool for evaluating the heart |
echocardiogram |
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what does the P wave represent on an electrocardiograph |
electrical conduction through the atrium |
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what does the QRS wave represent on an electrocardiograph |
electrical conduction of the ventricles |
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what does the T wave represent on an electrocardiograph |
ventricular repolarization |
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afterload |
the amount of blood left in the heart after contraction |
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clinical signs of canine dilated cardiomyopathy |
-right sided failure (ascites, hepatomegaly, weight loss) -left sided failure (pulmonary edema, syncope, coughing) -weakness -lethargy -shock -exercise intolerance - +/- gallop rhythm or tachyrhythm -greater risk for arrhythmias because of the changes in the heart structure |
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diagnosis of canine dilated cardiomyopathy |
-radiographs (generally have higher vertebral heart score) -echocardiogram -electrocardiograph (ECG) -pro-BNP test |
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clinical signs of canine hypertrophic cardiomyopathy |
-fatigue -cough -syncope -tachypnea -sudden death -asymptomatic -murmurs may be seen -depends on the severity of the disease |
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diagnosis of canine hypertrophic caridomyopathy |
-echocardiogram: must be done on echo, won't see muscle enlargement on radiographs because muscle is thickening on the inside of the heart |
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why won't you see heart enlargement on radiographs with canine hypertrophic cardiomyopathy |
because the muscle is thickening inward |
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treatment of canine hypertrophic cardiomyopathy |
-none -sudden death or congestive heart failure: can try supportive care for signs of congestive heart failure -cannot treat the underlying cardiac disease |
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prognosis of canine hypertrophic cardiomyopathy |
-poor -can result in sudden death or congestive heart failure -cannot treat the underlying cardiac disease |
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which breeds are most commonly affected by feline hypertrophic cardiomyopathy |
-ragdolls -persians -maine coons -british and american short hairs |
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clinical signs of feline hypertrophic cardiomyopathy |
-sudden death -soft murmur -gallop rhythms -acute onset of congestive heart failure or thromboembolism -saddle thrombus |
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diagnosis of feline hypertrophic cardiomyopathy |
-radiographs -ECG -echocardiogram -laboratory work up: ProBNP, rule out hyperthyroidism |
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rales aka |
crackles |
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rales (crackles) |
fluid in the lung causing the alveoli to stick together and make a crackling noise |
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wheezing |
disturbance in the airflow in the bronchi and trachea |
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endocardiosis |
thickening and age related to change int he valve unti |
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endocarditis |
changes in the heart valves seen secondary to dental disease |
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what is the most common cardiac disease seen in dogs |
chronic mitral valve disease |
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what are the 2 main causes of acquired heart murmurs |
-enlarged heart -damaged valve leaflets |
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what is the most common congenital defect in dogs and cats |
ventricular septal defect (VSD) |
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what is the most common cause of congenital murmurs in dogs and cats |
ventricular septal defect (VSD) |
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ventricular septal defect |
-ventricular foramen is slow to close -the ventricular septum should be a solid wall and in VSD there is a hole in this wall varying in severity -may close on its own -often innocent |
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when should the ventricular foramen close |
by 6 months of age |
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which species are ventricular septal defects common in |
very common in cats |
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how is a ventricular septal defect diagnosed |
verified on echocardiogram |
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what can sever cases of ventricular septal defect lead to and what increases the likelihood |
-severe cases may lead to heart failure -the larger the hole, the more significant the cardiac murmur which could be life threatening |
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what does stenosis mean |
narrowing |
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which blood vessels carry blood away fromt he heart |
arteries and arterioles |
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which blood vessels carry blood towards the heart |
veins and venules |
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capillaries |
tiny vessels where tissue exchange occurs (blood and gas exchange) |
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what is the pathway of blood through the heart |
-coronary sinus and cranial and caudal vena cava -right atria -tricuspid valve -right ventricle -pulmonary valve -pulmonary artery -lungs -pulmonary vein -left atria -mitral valve -left ventricle -aortic valve -aorta |
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plasma in blood consists of |
water and proteins |
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the cellular components of blood are |
red blood cells white blood cells platelets |
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the 2 phases of the cardiac cycle |
systole diastole |
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systole |
ventricular contraciton |
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diastole |
ventricular relaxation |
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clinical signs of heart disease |
-history -lack of stamina -poor growth -lethargy -cyanosis -exercise intolerance -restless at night -cough |
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syncope |
loss of consciousness specific to a cardiac event |
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occult |
has a disease but shows no clinical signs |
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paresis |
weakness |
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breeds predisposed to patent ductus arteriosus |
newfoundlands poodles |
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clinical signs of patent ductus arteriosus |
-small for age (stunted growth) -exercise intolerance -lethargy -cyanosis |
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diagnosis of patent ductus arteriosus |
-auscultaiton (continuous machinery murmur, grade III+) -echocardiogram |
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treatment of patent ductus arteriosus |
-surgery (ligate the ductus) |
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prognosis of patent ductus arteriosus |
-good with treatment -not good without treatment (shortened life expectancy, 64% will die within 1 year of diagnosis) |
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breeds predisposed to canine hypertrophic cardiomyopathy |
-german shepehrds -rottweilers -dalmations -boston terriers -cocker spaniels -shih tzus |
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clinical signs of boxer cardiomyopathy |
-syncope -weakness -if asymptomatic are normal on physical exam -ascites -tachyrhythmia or murmur on auscultation -sudden death -heart failure |
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diagnosis of feline dilated cardiomyopathy |
-clinical signs -radiographs -lab work -ultrasounds -ECG |
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what is the function of the cardiovascular system |
-regulate the flow of blood through vessels and capillaries -maintain homeostasis |
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which valves are the atroventricular valves |
-bicuspid (mitral) valve -tricuspid valve |
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bicuspid (mitral) valve |
separates the left atrium from the left ventricle |
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which valve separates the left atrium from the left ventricle |
bicuspid (mitral) valve |
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which valve separates the right atrium from the right ventricle |
tricuspid valve |
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tricuspid valve |
separates the right atrium fromt he right ventricle |
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pulmonic valve |
separates the right ventricle from the lungs |
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which valve separates the right ventricle from the lungs |
pulmonic valve |
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aortic valve |
separates the left ventricle and the aorta |
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which valve separates the left ventricle and the aorta |
aortic valve |
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sinoatrial (SA) node |
the pacemaker of the heart |
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what is the pacemaker of the heart |
sinoatrial (SA) node |
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what does the "lub" sound of the heartbeat correspond with |
the closing of the mitral and tricuspid valves as the ventricles contract |
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what does the "dub" sound of the heartbeat correspond with |
the closure of the pulmonary and aortic valves as the atria contract |
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which must contract first, the atria or the ventricles? |
the atria must contract before the ventricles |
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when does systole occur in the cardiac cycle |
between S1 and S2 of the cardiac cycle |
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when does diastole occur in the cardiac system |
between S2 and the next S1 |
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what does S1 correspond with in the cardiac cycle |
closure of the mitral valves |
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what does S2 correspond with in the cardiac cycle |
closure of the pulmonic and aortic valves |
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gallop rhythm |
an extra beat in the cardiac cycle |
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constricting the arteries leads to |
-hypertension -increases the force of blood through the capillaries |
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dilating the arteries leads to |
hypotension |
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if the veins are constricted what happens to blood flow |
it is reduced |
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if veins are dilated what happens to blood flow |
it is increased hw |
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what are the 2 ways the body can increase cardiac output for itself |
-increase heart rate -increase force of contraction |
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cardiac output = |
stroke volume x heart rate |
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stroke volume |
volume of the blood the heart pumps out |
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what knowledge plays an important role in how we treat cardiac disease |
it is easier for the pump to pump less viscous fluid through larger diameter tubes |
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what does it mean if clinical signs are compensated |
-the animal has clinical signs but is stable |
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what does it mean if the clinical signs are decompensated |
-the body cannot compensate for the defect -the animal is not stable |
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normal respiration rate for dogs |
10-30 rpm |
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normal respiration rate for cats |
20-30 rpm |
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what is a normal sinus arrhythmia and who gets them |
-in some dogs, the heart rate changes depending on the animal's breathing - this is normal a normal arrhythmia and is NOT pathological (when seen in dogs) -the heart rate tends to increase on inspiration and decrease on expiration
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common arrhythmias seen in animals |
-normal sinus arrhythmia -sinus tachycardia -atrial premature contraction -atrial fibrillation/flutter -sick sinus syndrome -ventricular tachyarrhythmia -ventricular premature contractions (VPC) -sinus bradycardia |
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what is sinus tachycardia |
-an arrhythmia -increased heart rate because of the increased input from the neuroendocrine system -normal heart beat/response to structure/physiology |
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what is seen on ECG with sinus tachycardia |
normal PQRST complexes |
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what is atrial premature contraction |
-an arrhythmia -atria contracting abnormally early (abnormal rhythm) -could lead to ventricular tachycardia |
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what is seen on ECG with atrial premature contraction |
-saw-tooth appearance to P-wave |
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what is an atrial fibrillation/flutter |
-an arrhythmia -originates in the atria -no rhythm to the atrial contractions or absence of atrial contractions |
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what is seen on ECG with atrial fibrillation/flutter |
an absence of P wave |
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what is sick sinus syndrome |
-an arrhythmia -an interruption of normal electrical conduction going from the SA node to the ventricles -an extremely low heart rate |
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what is seen on ECG with sick sinus syndrome |
long delays between P wave and QRS wave and T wave |
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what is ventricular tachyarrhythmia |
-ventricles are contracting faster and faster and often out of sync -ventricles are contracting too quickly not allowing enough time to fill, leading to ventricular premature contraction or ventricular fibrillation |
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what is ventricular premature contraction (VPC) |
-an arrhythmia -ventricles are contracting on their own without a pattern |
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what is ventricular fibrillation |
-an arrhythmia -when there are enough ventricular premature contractions in a period of time ventricles end up not contracting at all and this is incompatible with life which leads to sudden death |
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what is sinus bradycardia |
-an arrhythmia -normally slow heartbeat of athletic breeds -commonly seen in addison's disease and with GI upset as well |
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what is seen on ECG with sinus bradycardia |
animal has normal complexes |
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how are cardiac murmurs diagnosed |
-auscultation -echocardiogram |
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what are some congenital cardiac murmurs |
-ventricular septal defects -pulmonic and aortic stenosis -patent ductus arteriosus |
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what is subaortic stenosis |
-cause of congenital cardiac murmurs -narrowing of aortic or pulmonic valves caused by thickening or fibrosis along the valves |
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what can subaortic stenosis lead to |
hypertorphy (enlarged muscle in the heart) because the muscle has to pump harder |
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which breeds are predisposed to subaortic stenosis |
-german shepherds -newfoundlands -boxers -golden retrievers |
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what type of murmur is produced with subaortic stenosis |
-soft to moderate murmur |
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signs of subaortic stenosis |
-variable: the more severe the stenosis the more likely the animal is to have clinical signs -none -exercise intolerance -syncope -sudden death |
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diagnosis of subaortic stenosis |
-breed -x-ray enlarged left side of the heart -x-ray enlarged right side of heart (pulmonic valve) -echocardiogram |
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treatment of subaortic stenosis |
-medical management: exercise restriction, atenolol (beta blockers) -balloon angioplasty -avoid breeding |
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what is a balloon angioplasty and what disease is it used to treat |
-a balloon is fed through the heart valves and inflated, as it inflates it breaks down the fibrosis in the valves -used to treat subaortic stenosis |
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what is patent ductus arteriosus |
-congenital murmur -mixing of blood from the aorta (oxygenated) with blood from the pulmonary artery (unoxygenated) -the left ventricle has a hard time keeping up with cardiac output -there is a shunt between these 2 vessels in utereo that should close within 12-24 hours after birth and if it does not this happens and leads to hyperperfusion |
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what is the name of the connective tissue the shunt between the pulmonary artery and the aorta should form within 12-24 hours after birth |
ligament arleriosm |
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what type of murmur is produced with patent ductus arteriosus |
-a machinery murmur/a continuous murmur -murmurs tend to happen at only one point in the cardiac cycle, not with patent ductus arteriosus |
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pulmonary edema |
-fluid in the tissue itself -hear crackles and rales -associated with left-sided heart failure |
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pleural effusion |
-fluid in the chest -lungs are sitting in the tissue and cannot expand fully -edge of the lung forms a scalloped appearance -associated with right-sided heart failure -cats are more prone to pleural effusion |
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are cats more prone to pleural effusion or pulmonary edema |
pleural effusion |
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what are we concerned with in right-sided heart failure/which symptoms indicate heart failure is right-sided |
-pleural effusion -ascites -hepatic congestion |
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what are we concerned with in left-sided heart failure/which symptoms indicate heart failure is left-sided |
pulmonary edema |
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what are we listening for when we auscultate the lungs |
-clear sounding -rales/crackles -wheezing |
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what do we check when evaluating the cardiovascular system on physical exam |
-mucus membranes (color and CRT) -auscultating the heart (rhythm and murmur) -auscultating the lungs (crackles/rales, wheezing) -assessing the quality of the respiration rate -body temperature -peripheral pulse quality (especially femoral pulse) -check for jugular distention |
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doppler is used for |
measuring blood pressure |
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which lab test should be run in a full cardiac work up |
-cbc -chem -thyroid panel -proBNP |
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what effect does hypothyroidism have on the heart and who are we worried about it affecting |
-bradycardia -dogs |
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what effect does hyperthyroidism have on the heart and who are we worried about it affecting |
-tachycardia -caats |
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what is proBNP |
-a heart specific stress hormone -an enzyme that changes in the presence of cardiac disease secondary tot he changes in the structure of the heart -there is a wide acceptable range so it is suggestive but not definitive |
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what forms of diagnostic imaging can be done to evaluate the cardiovascular system |
-radiographs -ultrasound -CT -MRI |
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what are we looking for on radiographs when evaluating the cardiovascular system |
-heart size (vertebral heart score) -lung involvement (the best way to evaluate the lungs is with x-ray -look for pleural effusion (right-sided failure) or pulmonary effusion (left-sided failure) |
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what test can be done using radiographs to evaluate heart size |
-vertebral heart score (VHS) |
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vertebral heart score (VHS) |
-measuring heart size on radiographs -do a survey x-ray in lateral recumbency including ribs T4-T12 -measure the long and short axis of the heart and find out how many thoracic vertebrae it measure to determine enlargement |
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what is an echocardiogram and what are the benefits of it |
-an ultrasound of the heart -provides real time evaluation of function by providing a real time image of the heart -non-invasive -the gold standard of evaluating the heart |
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what is the pathology of canine dilated cardiomyopathy |
-enlarged chambers of the heart -thinning of the ventricular walls -heart becomes flabby -heart is having trouble contracting blood forward which decreases stroke volume, decreases cardiac output, increases afterload |
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what effect does canine dilated cardiomyopathy have on blood flow |
-the heart is having trouble contracting blood forward -decreases stroke volume -decreases cardiac output -increases afterload |
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treatment options for canine dilated cardiomyopathy |
-no cure, the goal is to improve the quality of life -diuretics (lasix) -digoxin (increase the force of contraction of the heart) -enalpril (Ace inhibitor) -beta blockers (metoprolol, propranolol: slow down heart contractions) -pimobendon (vetmedin (vasodilator, helps heart bump more efficiently and increases force of contraction) |
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what is the goal of treating canine dilated cardiomyopathy |
-no cure, goal of treatment is to improve quality of life -try to undo/combat the compensating mechanisms put in place by the body as it tries to increase cardiac output |
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prognosis of canine dilated cardiomyopathy |
-die within 6 months - 2 years of diagnosis - +/- sudden death -early biomarkers -dogs can generally live longer if on meds but we do not start these meds until they are in congestive heart failure |
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what is doberman cardiomyopathy |
-form of dilated cardiomyopathy which is unique to dobermans and especially common in older ones |
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clinical signs of doberman cardiomyopathy |
-long occult phase -peracute-acute onset -doberman could be totally asymptomatic and drop dead -fulminate pulmonary edema -sudden collapse -blood nasal discharge -ascites -arrhythmias |
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diagnosis of doberman cardiomyopathy |
-breed -all of a sudden has clinical signs -clinical signs -radiographs -ECG (a 5 minute ECG test) -echocardiogram |
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what is a 5 minute ECG test, who is it performed on and why |
-a 5 minute ECG test can be done on dobermans -if an older doberman comes in and has a single VPC (ventricular premature contraction) in 5 minutes they should be evaluated for doberman cardiomyopathy |
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treatment of doberman cardiomyopathy |
-diuretics -ACE inhibitors -pimobendon |
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prognosis of doberman cardiomyopathy |
-grave -6 months - 2 years from diganosis |
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what is canine hypertrophic cardiomyopathy |
-a myocardial disease -as the muscle thickens the ventricles get smaller and there is less space for blood to occupy -thickening and loss of compliance of the left ventricular muscle -a decrease in stroke volume |
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which is more common, canine dilated cardiomyopathy or canine hypertrophic cardiomyopathy |
canine dilated cardiomyopathy is more common |
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what is boxer right ventricular cardiomyopathy |
-boxer cardiomyopathy (more so an arrhythmia) -usually occurs because fat is replacing the normal cardiac tissue |
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what are the etiological agents of boxer right ventricular cardiomyopathy |
-can have nutritional, genetic, or idopathic causes -tends to be an inherted autosomal dominant trait -runs in families |
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who is boxer right ventricular cardiomyopathy more likely to manifest in |
-more common in males than females -tends to manifest between 8-10 years |
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diagnosis of boxer cardiomyopathy |
-breed -proBNP test -ECG: arrhythmia, consistent VPC (may require a holter monitor) -echocardiogram |
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treatment of boxer cardiomyopathy |
-antiarrhytmic drugs: sotalol (betablocker), mexiletine -pimobendan (a universal vasodilator, also intrinsically helps to increase the force of contraction) -ACE inhibitors for vasodilation |
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prognosis of boxer cardiomyopathy |
-highly variable |
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what is the most common cardiomyopathy in cats |
feline hypertrophic cardiomyopathy |
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who does feline hypertrophic cardiomyopathy affect |
-more common in males than females -cat may be between 1-16 years old |
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what causes feline dilated cardiomyopathy |
-taurine deficiency -genetic predisposition |
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clinical signs of feline dilated cardiomyopathy |
-older cats, mixed breed -dyspnea -inactivity -anorexia -acute lameness (paresis or paralysis usually from a thrown clot from the heart) -hypothermia -pain or lack of circulation in affected limbs |
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treatment of feline dilated cardiomyopathy |
-taurine supplement if taurine is the origin -diuretics (furosemide/lasix - use for congestive heart failure) -The following can be used to increase cardiac output: digoxin, pimobendan, enalapril (ace inibitors), hydralazine |
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prognosis of feline dilated cardiomyopathy |
-good for those that survive the 1st 2 weeks of diagnosis and respond well to treatment (taurine) -poor if non-responsive to taurine |
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who is affected by feline restrictive cardiomyopathy |
-any age cat but middle-aged cats to older cats tend to be overrepresented -more common in pure breeds |
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clinical signs of restrictive cardiomyopathy |
-respiratory distress -cyanosis -ascites -murmur -arrhythmia -pleural effusion |
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diagnosis of restrictive cardiomyopathy |
-clinical signs -radiographs -ECG -ultrasound |
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treatment of restrictive cardiomyopathy |
-diltiazem -aspirin -furosemide (to reduce fluid build up) -atenolo |
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prognosis of restrictive cardiomyopathy |
6 months from time of diagnosis |
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what are the 2 main categories of heart problems that can lead to congestive heart failure |
-myocardial failure (pump failure) -circulating failure |
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myocardial failures that can lead to congestive heart failure |
-cardiomyopathies -myocardium |
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what is the most common cause of congestive heart failure in dogs |
mitral regurgitation/mitral valve disease |
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what circulatory failures can lead to congestive heart failure |
-congenital defects: ventricular septic defect, patent ductus artereiosis, stenosis of aortic or pulmonic valves -valvular diseases: mitral regurgitation, tricuspid regurgitation |
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other disease processes that can lead to congestive heart failure |
-anemia -hypovolemia |
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what is congestive heart failure |
-blood that's returning to the heart cannot be pumped out at rate to meet the body's needs -structural or physiologic changes in heart increases load |
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which valves are usually invovled in acquired murmurs |
-the tricuspid valve -the mitral valve |
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what is the main cause of an acquired murmur |
-insufficiency in tricuspid and mitral valves -usually second to damage to the valve leaflets |
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what are the 2 causes of an acquired murmur |
-enlarged heart -damage to valve leaflets |
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when do acquired murmurs usually occur |
later in life |
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arrhythmias |
-abnormal electrical conduction of the heart, the electrical conduction originates somewhere other than the sinoatrial node |
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what are the 2 potential causes for arrhythmias |
-electrical impulses originating somewhere other than the sinoatrial node -changes in the connective route of the impulse (Abnormal impulse conduction |
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what effect do arrhythmias have on blood flow |
-arrhythmias lead to a decrease in cardiac output which leads to a decrease in cerebral outflow (blood flowing to the brain) |
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how are arrhythmias diagnosed |
-auscultation -ECG |
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what types of ECG monitoring can be done to test for an arrhythmia |
-rhythm strip (measuring an ECG for that moment in time) -full ECG -transtelephonic ECG (cardio pet) -computer assisted ECG -holter monitors |
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what is a cardio pet |
an ECG that is performed by hooking the leads to the animal while in clinic, putting a phone up tot the ECG and having a board-certified cardiologist on the phone to evaluate |
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what is a holter monitor |
-a portable ECG -attach electrodes and attach battery back and the animal wears for a minimum of 24 hours to record when and how often they have an event |
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what is the goal of treating arrhythmias |
-to allow the heart of fill as much as possible before pumping |
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an animal comes in with an atrial arrhythmia, does it have underlying heart disease |
-if it is a dog it may or may not, but know larger dogs are more susceptible to have underlying heart disease as the cause -if it is a cat, it always has an underlying heart disease |
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medications given for atrial fibrillation are |
-generally used to slow the arrhythmia and slow tachycardia so the heart can flow -digoxin -diltiazem -verapamil |
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what will you see occur as atrial arrhythmias persist |
development of congestive heart failure |
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which breeds are particularly prone to episodes of sudden death from ventricular tachycardia |
-german shepherds -boxers |
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if testing reveals ventricular premature contractions at what rate, the animal is at high risk for sudden death and should be put on meds |
- >25 per minute |
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what is another risk factor for sudden death for animals with VPC |
-tachycardia |
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what are the clinical signs of ventricular tachycardia |
-weakness -syncope -sudden death -can lead to congestive heart failure |
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what is the prognosis for ventricular tachycardia |
-guarded unless the underlying cause of the arrhythmia can be resolved |
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what heart rate indicates sinus bradycardia in dogs |
-70 bpm or less |
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name some diseases that can contribute to sinus bradycardia |
-hypothyroidism -GI Disorders -increased intracranial pressure -addison's disease (lack of production of corticosteroids by the adrenal gland) |
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clinical signs of sinus bradycardia |
-may be asymptomatic -weakness -syncope -collapse
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innocent murmurs are often |
congenital |
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acquired murmurs are often indications of |
heart disease |
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what is a cardiac mumur |
-disturbance of blood flow through the heart -back flow through the valves |
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which species is notorious for having abnormal sounding blood flow in the heart when they are particularly stressed |
cats |
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are all congenital murmurs innocent? |
no, some are indications of a shortened life span |
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what are some etiologies of congenital murmurs |
-ventricular septal defects (VSD) -pulmonic and aortic stenosis -patent ductus arteriosus |
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an innocent congenital murmur has often self-resolved/disappeared by what age |
5-6 months |
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what is the treatment for an acquired murmur |
-no cure -not a lot can be done to delay progression of disease, mostly we just wait until clinical signs/structures change and treat those |
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what can acquired murmur lead to |
-congestive heart failure -ascities -pulmonary effusion -pulmonary edema |
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how are acquired murmurs diagnosed/evaluated |
-heard on auscultation -echo to evaluate where the deformity is and if structural changes have occured -x-ray to evaluate lungs |
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what are the 3 forms of feline cardiomyopathies |
-dilated -hypertrophic -restrictive |
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what is the cause of a feline cardiomyopathy |
in general, idiopathic |
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what is the prognosis of a feline cardiomyopathy |
poor long term prognosis |
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treatment of feline hypertrophic cardiomyopathy |
-beta blockers to slow heart (atenolol, propranolo) -calcium channel blockers (diltiazem) -aspirin -ACE inhibitors -diuretics (furosemide) |
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why is aspirin given in cases of feline hypertrophic cardiomyopathy |
-because cats have very reactive platelets and cats are more susceptible to developing clots in the heart which can break off and lodge into different vessels -apsirin breaks down the current clots or prevents the clot from forming |
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prognosis of feline hypertrophic cardiomyopathy |
mean survival after diagnosis is 2 years |
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clinical signs of thromboembolism |
-acute onset of rear leg pain/paresis/paralysis -decreased circulation to area -cold foot pads -pulse deficits -history of myocardial disease |
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treatment of thromboembolism (especially saddle thrombi) |
-not very successful -TPA -herparin -prophylactic aspirin |
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what is the prognosis of thromboembolism |
guarded to poor |
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what is the rate of saddle thrombi in hypertrophic cardiomyopathy |
-90% |
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what is the rate of thromboembolism in cats with hypertrophic cardiomyopathy |
10-20% |
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class B congestive heart failure is what in the old system |
1 |
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class C congestive heart failure is what in the old system |
2-4 |
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class D congestive herat failure is what in the old system |
4 |
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what is class A congestive heart failure |
-high risk breeds -no abnormalities -no meds warrented at this stage |
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what is class B (old 1) congestive heart failure |
-early or compensated -murmur on PE -normal x-ray -EKG normal -echo may show regurg in one of the AV valves -no meds warrented at this stage |
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what is class C (old 2-3) congestive heart failure |
-compensated clinical signs -cardiac murmur and some clinical signs but the body is compensating for the defect |
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what is class D (old 4) congestive heart failure |
-decompensated clinical signs -refractory disease -animal is not responding to medical management |
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what are the symptoms of class C congestive heart failure |
-coughing (especially at night, restlessness) -exercise intolerance -ascites -syncope -pulmonary edema -arrhythmias |
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diagnosis of class C congestive heart failure |
-lab work: Pro BNP -x-rays -echo |
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treatment of class C congestive heart failure |
-diet -diuretics -ACE inhibitors (enlaparil, benazepril) -pimobendan -restrict exercise (restricting exercise restricts the oxygen demand on the body) |
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what is stage D congestive heart failure, what are the signs, prognosis, etc. |
-respiratory distress at rest -uncompensated congestive heart failure -oxygen cage for treatment/management -digitalis for treatment/management -cyanosis -grave prognosis -end stage heart failure |
