Term
| True or False: Common congenital diseases are assoc w/ soft heart murmurs. |
|
Definition
| -FALSE, they are usually assoc w/ loud murmurs |
|
|
Term
| What is the most common location for pulmonic stenosis in dogs |
|
Definition
|
|
Term
| What is valvular pulmonic stenosis? |
|
Definition
| -fusion of the semilunar leaflets |
|
|
Term
| What do we hear on auscultation s/ pulmonic stenosis? |
|
Definition
| -left basilar systolic murmur WITH NORMAL PULSES |
|
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Term
| True or False: Severity of pulmonic stenosis often correlates to intensity of murmur. |
|
Definition
|
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Term
| How do we treat pulmonic stenosis? |
|
Definition
|
|
Term
| What is our concern w/ ballooning pulmonic stenosis in English bulldogs? |
|
Definition
-they can have single trunk for coronary a where the left a encircles the pulmonary a thus it can be torn when ballooning
-can occur in Boxers as well |
|
|
Term
|
Definition
| -patent connection b/n main pulmonary artery and aorta instead of becoming ligamentum arteriosum like it should |
|
|
Term
| What is the most common congenital heart defect in the dog? |
|
Definition
|
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Term
| How do we test the efficacy of ballooning a pulmonic stenosis? |
|
Definition
| -measure blood speed through valve and hopefully it will be half of what it was before surgery |
|
|
Term
| Why do we need a ductus arteriosus in utero? |
|
Definition
| -shunts blood away from non-functional lungs to allow right heart development |
|
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Term
|
Definition
-murmur is pathognomonic for PDA
-echo to definitively diagnose
-hyperdynamic (water hammer) femoral pulses |
|
|
Term
| What kind of murmur do we get w/ a PDA? |
|
Definition
| -washing machine murmur: never stops |
|
|
Term
| what do we see on echo w/ PDA? |
|
Definition
-LV dilation
-high velocity blood flow into pulmonary a |
|
|
Term
|
Definition
-surgical ligation or ductal occlusion recommended
-do it when they are little |
|
|
Term
| What happens w/ PDA w/out surgery? |
|
Definition
| -left-sided V overload & HF |
|
|
Term
| How do we surgically fix a PDA? |
|
Definition
-IV occlusion: ACDO > Coil/Plug
-ACDO = Amplatz Canine Ductal Occluder
-OR ligation |
|
|
Term
| What is our major concern w/ surgical ligation of PDA? |
|
Definition
| -dissection behind ductus is the most critical point b/c it can tear |
|
|
Term
| What is the major advantage of surgical ligation w/ PDA? |
|
Definition
| -side of the heart is irrelevant but needs to be big enough w/ IV occlusion |
|
|
Term
| How do we determine if you were successful when fixing a PDA? |
|
Definition
| -if there is still a murmur then not successful |
|
|
Term
| What is the most common congenital lesion across species? |
|
Definition
|
|
Term
| What kind of murmur will we heart w/ VSD? |
|
Definition
| -systolic murmur right caudal sternal border |
|
|
Term
| What is the most common form of VSD? What does it physiologically cause? |
|
Definition
-paramembranous (can also be muscular or subpulmonic)
-L-sided V overload due to majority of shunting in systole |
|
|
Term
| Do we want high or low velocity flow w/ VSD? |
|
Definition
|
|
Term
|
Definition
-most sifnificant shunts die prior to vet exam
-paramembranous defects not good candidates
-consider pulmonic banding if hemodynamically unstable |
|
|
Term
| What is the typical murmur w/ subaortic stenosis? |
|
Definition
-often loud left basilar systolic mumur
-severity correlates w/ intensity of murmur |
|
|
Term
| What other clinical signs do we see w/ subaortic stenosis? |
|
Definition
| -weak pulses assoc w/ rate of rise of systolic pressure |
|
|
Term
| How can we differentiate subaortic & pulmonic stenosis of PE? |
|
Definition
-weak pulses = subaortic
-normal pulses = pulmonic |
|
|
Term
| What are the physiological consequences of subaortic stenosis? |
|
Definition
| -concnetric hypertrophy in LV to maintian BP |
|
|
Term
| How do we fix subaortic stenosis? |
|
Definition
-not good candidate for balloon or open heart
-often prescribe beta blocker (atenolol)
-treat for CHF when develops |
|
|
Term
| IN which dogs is tricuspid dysplasia most common? |
|
Definition
|
|
Term
| What kind of murmur do we hear w/ tricuspid dysplasia? What happens physiologically? |
|
Definition
-right apical systolic murmur
-valve thickening, shortened chordal structures, abnormal valve opening (Stenosis), tethering of leaflets
-varying degrees of dysplasia |
|
|
Term
| What is a common ECG issue seen w/ tricuspid dysplasia? |
|
Definition
|
|
Term
| What kind of arrhythmias are common w/ tricuspid valve dysplasia? |
|
Definition
|
|
Term
| How do we treat tricuspid valve dysplasia? |
|
Definition
| -furosemid, enalapril, & pimobendan ONCE THEY ARE IN CHF |
|
|
Term
| What do we see physiologically due to mitral valve dysplasia? |
|
Definition
| -valve thickening, shortened chordal structures, abnormal valve opening (stenosis), tethering of leaflets |
|
|
Term
| Is mitral or tricuspid valve more likely to be stenotic? |
|
Definition
|
|
Term
| Where do we heart a murmur w/ mitral valve dysplasia? |
|
Definition
|
|
Term
| HOw do we treat mitral valve dysplasia? |
|
Definition
-early ACE inh when volume overload
-treat CHF when develops
-treat arrhythmias
-surgically treat if you can |
|
|
Term
| What are the physiological issues caused by atrial septal defects? |
|
Definition
-right-sided V overload
-often no to soft murmur
-split S2 |
|
|
Term
| IN which animals does ASD become hemodynamically significant most commonly? |
|
Definition
-Standard Poodles
-close it like a PDA |
|
|
Term
| What is reversal of PDA/ASD/VSD? Clinical signs? |
|
Definition
-time & severity leads to pulmonary hypertension leading to eventual R to L shunting
-dyspnea and exercise intolerance
-reversal cyanosis w/ reverse PDA |
|
|
Term
| HOw do we treat pulmonary hypertension w/ reverse PDA? |
|
Definition
-Sildenafil
-L-arginine
-Pimobendan |
|
|
Term
| What is Polycythemia? How do we treat it? |
|
Definition
-way too many RBCs
-tx w/ phlebotomy or Dyrdoxurea |
|
|
Term
| What are the systemic effects of persistent right aortic arch (PRAA)? |
|
Definition
-often no patent blood flow
-GI regurge w/ esophageal dilation |
|
|
Term
| How do we approach Peritoneal Pericardial Diaphragmatic Hernia (PPDH)? |
|
Definition
-abnormal fusion of septum tranasversum w/ pleuroperitoneal folds during embryonic development
-doesn't always need to treat |
|
|
Term
| What is the really common sign w/ Tetralogy of Fallot? |
|
Definition
|
|
Term
| What is the Tetralogy of Fallot? |
|
Definition
| -right ventricular hypertrophy + pulmonic stenosis + VSD + overriding aorta |
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