Cardiovascular Disease

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Author:
kris10leejmu
ID:
198263
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Cardiovascular Disease
Updated:
2013-03-18 07:19:09
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Animal Diseases Two
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Animal Diseases
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  1. What does the heart do?
    pump circulates blood through vessels
  2. What do vessels do?
    deliver contents in blood to cells and removes waste
  3. How many chambers of the heart are there?
    4
  4. What generates the electrical impulse in the heart?
    sinoatrial node in myocardium
  5. Where does the contraction of the heart happen?
    myocardium
  6. What are the basic functions of the heart?
    • oxygen and nutrient transport
    • transport of waste for excretion
    • distribution of hormones, enzymes, through the body
    • thermoregulation
    • urine formation
  7. Is the heart voluntary or involuntary?
    involuntary
  8. What is the heart controlled by?
    the autonomic nervous system
  9. What does heart disease do to the heart?
    failure to pump which affects functions of the entire body
  10. What are the different types of heart disease?
    • congestive heart failure (CHF)
    • cardiomyopathy (CM)
    • congenital heart disease 
    • acquired valvular disease
    • traumatic myocarditis
  11. What is heart failure?
    body is unable to pump enough blood to meet the body's needs
  12. What happens to most heart failure cases when the heart worsens?
    becomes congested
  13. What is congestive heart failure?
    when fluid accumulates in the body
  14. What is left sided congested heart failure?
    pulmonary edema
  15. What is right sided congested heart failure?
    ascites, liver failure
  16. What are the clinical signs of left sided congestive heart failure?
    • labored breathing 
    • exercise intolerance
  17. What are the clinical signs of right sided congestive heart failure?
    • pleural effusion
    • hepatomegaly
    • jugular distension
  18. What are the clinical signs of canine heartworm disease?
    • coughing
    • exercise intolerance
    • weight loss
    • signs of right heart failure
  19. What does cardiomyopathy in dogs?
    dilated cardiomyopathy
  20. What does cardiomyopathy in cats?
    hypertrophic cardiomyopathy
  21. What does do we often see dilated cardiomyopathy in?
    older, male, large and giant breeds
  22. What is dilation of the heart chamber due to in dilated cardiomyopathy?
    due to weak, thin myocardium
  23. What does dilated cardiomyopathy result in?
    results in decreased cardiac output
  24. What causes dilated cardiomyopathy?
    etiology unknown
  25. What are the clinical signs of dilated cardiomyopathy?
    • asymptomatic
    • arrhythmias
    • episodic weakness, exercise intolerance
    • syncope
    • congested heart failure (right sided or left sided)
  26. What is syncope?
    fainting
  27. Do dogs have to have all the symptoms of dilated cardiomyopathy?
    no, they can have different combinations of these symptoms
  28. What are ways to diagnose dilated cardiomyopathy?
    • EKG - check for arrhythmias
    • radiology - normal to cardiomegaly, pulmonary edema
    • echocardiogram - dilation of chambers, abnormal contractility
    • holter monitor - EKG recording over 24 hours to check PVCs
  29. Is there a cure for dilated cardiomyopathy?  What do we do for dilated cardiomyopathy?
    • no, just keep the patient comfortable
    • diuretic to treat pulmonary edema
    • digoxin - increase contractility
    • enalapril - vasodilation 
    • antiarrhythmic drugs
  30. What is feline dilated cardiomyopathy?
    pathology similar to dogs
  31. What causes feline dilated cardiomyopathy?
    taurine deficiency
  32. What are the clinical signs of feline dilated cardiomyopathy?
    • middle aged or older cats
    • dyspnea
    • respiratory distress
    • acute rear limb paralysis
    • thromboembolism - saddle thrombus
    • heart murmur (gallop rhythm)
    • cardiomegaly, pulmonary edema, and pulmonary effusion seen on radiograph
    • decreased plasma taurine levels
  33. How do we treat feline dilated cardiomyopathy?
    • taurine supplementation
    • diuretic
    • digoxin, enalapril
    • thromboembolism - heparin, sedation
    • prevent thromboembolism - aspirin
  34. What is feline hypertrophic cardiomyopathy?
    • left ventricular hypertrophy
    • increased ventricular muscle mass - decreased size of lumen
  35. What causes feline hypertrophic cardiomyopathy?
    etiology unknown
  36. What are the clinical signs of feline hypertrophic cardiomyopathy?
    • soft murmur (grade 2- 3/6)
    • gallop rhythm or other arrhythmia
    • acute heart failure
    • thromboembolism
    • dyspnea
    • sudden death
  37. How do we diagnose feline hypertrophic cardiomyopathy?
    • radiographs:  heart normal to cardiomegaly, pleural effusion seen 
    • EKG:  possible arrhythmias
    • ultrasound:  increased left ventricular wall thickness, dilated left atrium
  38. What is the therapy for feline hypertrophic cardiomyopathy?
    • diuretic
    • thoracocentesis
    • beta blockers or calcium blockers for tachycardia, outflow obstruction
    • aspirin for thromboembolism
  39. Is canine hypertrophic cardiomyopathy common in dogs?
    no
  40. Is canine hypertrophic cardiomyopathy similar to feline hypertrophic cardiomyopathy?
    yes
  41. What causes congenital heart disease?
    • malformation of the heart
    • malformation of the great vessels
    • genetic basis
    • breed predilections
  42. How do we diagnose congenital heart disease?
    • good history
    • special attention to breed, age, and sex
    • physical exam with auscultation
  43. What are the clinical signs of congenital heart disease?
    • failure to grow as a puppy
    • dyspnea
    • weakness
    • syncope
    • seizures
    • sudden death
    • cyanosis
    • no symptoms
    • loud murmur
    • precordial thrill (vibration)
    • pulse abnormalities
    • jugular pulse
    • abdominal distension
  44. How do we diagnose congenital heart disease?
    • lab work may be normal
    • radiographs:  may suggest cardiac diseases - heart enlargement, pleural fluid, pulmonary edema
    • ultrasound:  echocardiogram - can provide an accurate diagnosis
  45. What are the three types of congenital heart disease?
    • patent ductus arteriosus (PDA)
    • septal defects (atrial and ventricular)
    • stenotic valves (aortic and pulmonic)
  46. Which congenital heart disease is the most common?
    patent ductus arteriosus (PDA)
  47. What does the ductus arteriosus normally do?
    normally carries blood from the pulmonary artery to the aota in the unborn baby
  48. When does the ductus arteriosus normally close in the neonate?
    12 - 24 hours after birth
  49. What is patent ductus arteriosus?
    ductus arteriosus does not close and there is an abnormal persistent communication between the pulmonary artery and the aorta
  50. Is PDA more common in females or males?
    females
  51. What are the clinical signs of PDA?
    • loud murmur on left thorax
    • machinery murmur
    • congestive heart failure
    • can be asymptomatic
  52. How do we diagnose PDA?
    • EKG may show abnormalities
    • radiographs:  left atrial and ventricular enlargement
    • ultrasound:  echocardiogram
  53. What is the treatment for PDA?
    • surgery should be done by 2 years of age
    • prognosis is excellent unless advanced disease is present
  54. _____ of affected animals with PDA will die within 1 year without surgery.
    50%
  55. Do murmurs usually resolve with PDA?
    yes
  56. What will happen with the overall heart size with PDA?
    heart size will normalize but will remain misshapen
  57. What are the two different septal defects?
    • atrial septal defect
    • ventricular septal defect
  58. What is atrial septal defect?
    defects in the septum that separates the atria and overloads the right heart
  59. What is ventricular septal defects?  What animals is this common in?
    • overloads the left heart
    • common in both dogs and cats
  60. What is the most common treatment for septal defects?
    • surgery is not commonly done
    • medical management of the resulting congestive heart failure is the most common type of treatment
  61. What are the three different types of stenotic valves?
    • aortic
    • pulmonic
    • dysplastic or malformed valves
  62. Which animals do we typically see aortic stenosis in?
    large breed dogs
  63. When do we see aortic stenosis?
    develops during 4 - 8 weeks of life
  64. What is aortic stenosis?
    • thickening below valve
    • obstruction of outflow
  65. What are the clinical signs of aortic stenosis?
    • ejection murmur (left)
    • tires on exertion
    • syncope
    • left congestive heart failure
    • sudden death
    • asymptomatic
  66. How do we diagnose aortic stenosis?
    • radiographs and EKG are abnormal with moderate to severe disease
    • left heart enlargement
    • ultrasound:  echocardiogram - outflow obstruction of the aorta
  67. What are the kinds of treatments for aortic stenosis?
    • balloon catheter to dilate 
    • surgery
    • medical management of clinical signs
  68. What is pulmonic stenosis?
    • pulmonic valve
    • dysplasia, malformed
    • obstruction to right heart outflow
    • right atrium enlarges
  69. What are the clinical signs of pulmonic stenosis?
    • over 1 year old
    • syncope
    • tires on exertion
    • jugular pulse
    • murmur
    • right ventricular enlargement
    • right congestive heart failure
    • asymptomatic
  70. How do we diagnose pulmonic stenosis?
    • radiographs and EKG:  right ventricular enlargement
    • ultrasound:  echocardiogram - obstructive lesion in pulmonic valve area
  71. How do we treat pulmonic stenosis?
    • balloon valvuloplasty
    • surgery not commonly done due to high cost and mortality
    • medical management
  72. What is the most common heart disease in an adult?
    acquired valvular disease
  73. What are the two types of acquired valvular disease?
    • chronic mitral valve insufficiency (CMVI)
    • tricuspid valve insufficiency
  74. What are some other names of chronic mitral valve insufficiency (CMVI)?
    • left atrioventricular valve
    • bicuspid valve
  75. Which dogs are typically affected by CMVI?
    dogs over 16 years old
  76. CMVI causes _____ of all cases of congestive heart failure in small breed dogs.
    95%
  77. What does CMVI do to the heart?
    • thickening of free edges of valve
    • edges roll up and stiffen
    • valves do not close completely
    • regurgitation of blood causes the sound of the murmur
  78. What causes the coughing in CMVI?
    compression of the main bronchus
  79. What can the coughing also be called in CMVI?
    pulmonary edema
  80. What does periodontal disease do to the heart?
    causes CMVI
  81. How does periodontal disease cause CMVI?
    • gram negative bacteria live in periodontal pockets
    • bacteria shower the bloodstream and adheres to the valves
    • the valves thicken and fail to close
  82. What are the clinical signs of CMVI?
    • cough - worse at night and with exercise
    • dyspnea, tachypnea
    • decreased appetite
    • murmur (left systolic - swish dub)
  83. How do we diagnose CMVI?
    • radiographs:  pulmonary edema, left sided enlargement, elevation of thoracic trachea
    • EKG:  left sided enlargement
    • ultrasound:  abnormal shape, location, and motion of valve
  84. What is the treatment for CMVI?
    • goal is to maintain length and quality of life
    • diuretics
    • vasodilators
    • digoxins
  85. Is there a cure for CMVI?
    no
  86. What kind of diet does a patient with CMVI need to be on?
    low salt diet
  87. What is another name for tricuspid valve insufficiency?
    right atrioventricular valve
  88. What side of the heart does tricuspid valve insufficiency affect?
    the right side
  89. What are the clinical signs of tricuspid valve insufficiency?
    • pleural effusion
    • ascites
    • hepatomegaly
  90. Which is more common, CMVI or tricuspid valve insufficiency?
    CMVI
  91. How do we treat tricuspid valve insufficiency?
    • same as CMVI
    • may have to do abdominocentesis to relieve some of the fluid in the abdomen
  92. What causes traumatic myocarditis?
    blunt trauma to the chest
  93. When do we usually see traumatic myocarditis?
    hit by cars
  94. When does the arrhythmias occur with traumatic myocarditis and why is this important?
    • 24 - 72 hours after trauma
    • don't rush patient into surgery to fix any broken bones until you are sure there is nothing wrong with the heart
  95. How do we diagnose traumatic myocarditis?
    • EKG:  PVCs
    • radiographs:  pulmonary contusions, rib fractures, diaphragmatic hernia, pleural effusion
    • ultrasound:  echocardiogram is normal
  96. What is the treatment for traumatic myocarditis?
    • oxygen
    • antiarrhythmic drugs (lidocaine and procainamide)
  97. When does traumatic myocarditis resolve after the start of treatment?
    resolves in 72 - 96 hours

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