Sami Cardiac Exam

Front 1

What are the first things to note on a patient?

Back 1

Signalment (species, age and breed)

Front 2

What heart disease are more likely in young dogs?
Older dogs?

Back 2

congenital
acquired

Front 3

What common heart conditions are seen in large breed dogs?
Small Breeds?
Cats?

Back 3

Dilated cardiomyopathy
Atrioventricular valvular degeneration
Hypertrophic cardiomyopathy

Front 4

Which sided heart failure do you see coughing and dyspnea?
Ascites?

Back 4

left sided
right sided

Front 5

What is pulse?

Back 5

the perceived difference between the systolic and diastolic pressures in an artery

compare to auscultated heart rate

take pulse in femoral artery of dogs and cats

Front 6

What are the common causes of tachycardia?

Back 6

heart failure
shock
fear
excitement
exercise
pain

Front 7

What can cause an increase in temperature in relation to heart disease?
Decreased?

Back 7

may be elevated with myocarditis, valvular endocarditis, hyperthyroidism

heart failure most patients have normal temp

Front 8

What is a normal cause of a change in pulse rhythm?

Back 8

inspiration (respiratory sinus arrhythmia)
seen in brachyocephalic dogs

Front 9

What can cause weak pulse?

Back 9

-dilated cardiomyopathy
-shock
-Aortic Stenosis
-pericardial effusion

Weak pulse are called hypokinetic

Front 10

What is a waterhammer pulse?
What are causes of this?

Back 10

-strong pulse with sharp rise and fall in pulse pressure
-associated with variation between systolic and diastolic pressure, AV shunts and severe anemia

Front 11

What response is triggered by a decrease in blood pressure?

Back 11

sympathetic response - heart rate increases

Front 12

What can pale mucous membranes indicate?

Back 12

fear, left heart failure or shock

Front 13

What can cyanotic mucous membranes indicate?

Back 13

right to left shunts, severe left heart failure

Front 14

What does brick red mucous membranes indicate?

Back 14

erythrocytosis or right to left shunts

Front 15

What does a delayed CRT of the mucous membranes indicate?

Back 15

decrease left ventricular output or vasoconstriction from shock or fear

Front 16

What is the beat of the heart that is felt on the thoracic wall?
Where is this heard?

Back 16

-Apical beat
-Between 5th and 6th intercostal space where the mitral valve is located

Front 17

In what animal is the apical beat stronger?

Back 17

in an younger thinner animal

Front 18

What can cause a weak apical beat?

Back 18

-heart failure
-shock
-obesity
-emphysema
-effusion

Front 19

What position should the dog be in when auscultating the heart?

Back 19

standing

Front 20

What frequency does the bell of the stethoscope detect?
The diaphragm?

Back 20

low frequency
Higher frequencies

Front 21

What causes heart sounds?

Back 21

valve movements and/or turbulence in blood flow
-listen to both sides

Front 22

How many heart sounds are recognized?
How many are normally audible in dogs and cats?

Back 22

four
two

Front 23

What causes S1 sound?
Where is it heard?

Back 23

closure of AV valves
5th and 6th intercostal space (apical beat)

-lower, lower and louder than S2
-occurs after the longest period of silence and can be heard just before pulse can be palpated

Front 24

Where can S2 be heard?
What does is sound like compared to S1?

Back 24

-best heard over the aortic and pulmonary valves (4th intercostal space at point of shoulder, 3rd left intercostal space btwn point of shoulder and sternum.

-soft, shorter and higher pitched than S1

Front 25

When do you hear S3?

Back 25

abnormal to hear S3 in dog and cat and usually occurs with massive left ventricle enlargement

-rapid passive ventricular filling

Front 26

Where do you hear S4?

Back 26

occurs as a result of contraction of the atria and is usually not hear in the dog and cat
-can be heard with reduced ventricular compliance
--HCM in cats
--aortic stenosis in dogs

Front 27

If you heard an extra heart sound what is the next best thing to do?

Back 27

send the animal for an ultrasound

Front 28

What is a systolic click?

Back 28

-a sound heard in early signs of mitral valve degeneration

-occurs when the chordate tendinae snap tight as the degenerative mitral valve protrudes into the left atrium in mid systole

-seen in small breed dogs

Front 29

What are murmurs?
What causes them?

Back 29

-audible vibrations
-produced by turbulent flow

Front 30

What can murmurs indicate?

Back 30

-narrowing of vessels (pulmonic stenosis)
-valvular insifficency
-increased rate of blood flow
-decreased viscosity

Front 31

What animals are common to have murmurs?

Back 31

young puppies with anemia

Front 32

What type of murmur is common to hear in dogs and cats?

Back 32

systolic

Front 33

What is a holosystolic heart murmur?

Back 33

lub-swish-dub

Front 34

What is a pansystolic murmur?

Back 34

a murmur where you can only hear swishing over normal heart sounds

Front 35

What are diastolic murmurs?

Back 35

aortic or pulmonic valve insufficiency

rare in dogs and cats

Front 36

What are continuous murmurs?
What do they sound like?
What is a common cause?

Back 36

-occur during systole and diastole
-sounds like machinery
-patent ductus arteriosis

Front 37

How would you describe a murmur resulting from endocardiosis?

Back 37

A pathological grade 3/6 holosystolic murmur loudest over the mitral valve and radiating to tricuspid valve area

Front 38

How are murmurs grades?
Including and above this grade the murmur is heard on both sides of chest?

Back 38

Scale of 6, 1/6 - 6/6
4/6

Front 39

If you see jugular vein distension,what might that mean?

Back 39

right sided congestive heart failure
pericardial effusion