Cardiology

Front 1

Treatment for Chronic Acquired Degenerate Valvular disease (Common dogs, not cats)

Back 1

Restrict sodium
Restrict exercise
Diuretic (furosemide)
ACE Inhibitor or Pimobendan
Digoxin if A fib or supraventricular arrythmia
MAYBE B-blocker

Front 2

Treatment for DCM (dog) (5-6)

Back 2

Sodium restriction
Exercise restriction
Furosemide
ACE inhibitor and/or Pimobendan
Antiarrhythmic if needed (digoxin or B-blocker for A-fib, ventricular antiarrhythmic for V-fib)

Front 3

Treatment for HCM (Cat) (5)

Back 3

Sodium restriction
Furosemide
Diltiazem or B-blocker (avoid non-specific B-blockers if pulm. oedema present)
Nitrates
Antiarrythmics if needed

Front 4

What is Digoxin?
What does it do? (2 actions)
What do we use it for?

Back 4

Increases contractility (+ve inotrope) and decreases HR

Cardiac glycoside
Inhibits NaKATPase - positive inotrope.
Vagomimetic effects - slow HR, slow conduction across AV node.

Use for:
1. CHF - +ve inotrope: Increase SV, increase CO hence increase renal haemodynamics so diuresis. Result is decreased venous pressure and reduced end diastolic volume. PIMOBENDAN IS BETTER!

2. Supraventricular tachyarrythmias (MAIN USE)- slows HR, prolongs AV conduction time

Front 5

What is Pimobendan?
What does it do? (3 actions)
What do we use it for?

Back 5

Phosphodiesterase inhibitor

1. Vasodilation
2. Positive inotrope (increase contractility, by novel Ca-sensitizing method that does not increase cardiac muscle energy expenditure).
3. Inhibits renin-angiotensin-aldosterone system.

Use to treat mild, mod or severe CHF from valvular insufficiency or DCM

Front 6

What is Furosemide?
How does it work?
When do we use it?

Back 6

Loop diuretic
Inhibits Na and Cl resorption in ascending loop of Henle - hence natriuresis.
Reduces preload.
Use when congestion is present (pleural effusion, pulmonary oedema, ascites).

Front 7

What is Spironolactone?
When would you use it? (2)

Back 7

A K sparing diuretic. Weaker diuretic than furosemide. Block Na/K exchange hence promoting Na excretion and K retention.
Use if hypokalaemia is a problem, or for a mild diuretic effect once CHF is refractory after treatment with furosemide.

Front 8

What is an ACE-Inhibitor?
Name two.
What do we use it for?

Back 8

Inhibits Angiotensin II's vasoconstrictive effects on arteries and veins, and inhibits aldosterone release hence reducing renal retention of water. Reduce cardiac remodelling.

Angiotensin II is a potent vasoconstrictoe that also stimulates release of aldosterone from adrenal cortex (-water retention).

Use for chronic tx of CHF - takes a few weeks to see full effects. Some people use to slow heart enlargement and delay onset of CHF.

Front 9

What is Nitroglycerine?
What does it do?
What do we use it for?

Back 9

Venous vasodilator, also acts on coronary arterial bed.
Metabolised to Nitric oxide - relaxes venous smooth muscle.
Use to treat acute cardiogenic pulmonary oedema. Only use for 2-3 days (tolerance develops).

Front 10

What is Hydralazine? What does it do?

Back 10

Arterial vasodilator, no action on arterial beds though.
Use in mitral regurg, to decrease mitral regurg volume (-increases forward CO and reduces LA size, reduces pulmonary oedema).

Front 11

What are Beta-adrenergic blockers?
What do they do?
What do we use them for?

Back 11

We don't know how they work, still getting evidence of efficacy but so far looks promising.

Supraventricular tachyarrhythmias
Ventricular tachyarrhythmias
Reduce outflow obstruction
Treat sytemic hypertension.

Front 12

What is Diltiazem?
What does it do? (4)
What do we use it for?

Back 12

Ca channel blocker
Vasodilation, negative inotrope, negative chronotrope, slows conduction through AV valve.
Use for HCM