Cardio Exam 1 set 1

Preload

Afterload

Contractility

Heart Rate

Stroke Volume

Heart failure- a syndrome of clinical signs and associated neuroendicrine abnormalities that results from impaired emptying or filling of the heart

Heart disease- a structural or functional abnormality of the heart

Left-sided heart failure- characterized by elevations in central venous pressure that result in ascites, pleural effusion, or peripheral edema

All of these are correctly paired

Volume overloads- diseases that decrease the diastolic volume of the heart

Pressure overloads- diseases that increase systolic load often because of a decreased resistance to ventricular emptying

Contractile dysfunction- any functional or structural disorder of the sarcomeres can result in contractile dysfunction and the syndrome known as dilated cardiomyopathy

Diastolic dysfunction- diseases that impair atrial filling

What is the cardiac rate?

What is the cardiac rhythm?

Is the heart enlarged?

Is heart failure present?

What is the disease that has caused heart failure?

Cardiac dimensions using the vertebral heart score

Pulmonary vasculature

Concomitant diseases

Distinguishes between cardiomegaly and pericardial effusion

Chambers are easy to distinguish from each other

Arrhythmias (diagnosis and follow-up)

Conduction abnormalities

Monitoring anesthesia

Chamber enlargements

Electrolyte abnormalities

Severity of heart failure

All of the above

Thoracic radiographs: clinical signs such as cough or dyspnea are present

ECHO: the cause of and enlarged radiographic cardiac silhouette is unclear and/or when a definitive etiologic diagnosis of heart disease is important

ECG/EKG: when the heart rate is inappropriately high, inappropriately low, or inappropriately irregular

ECHO and ECG only

Rads and ECHO only

All of the above

Relatively mild heart disease can compromise exercise performance/tolerance in athletes. Sedentary animals don't usually have signs of exercise intolerance until cardiac disease is advanced.

Cough that persists for months or years without treatment is most often due to cardiac disease.

Tachypnea/hyperpnea/respiratory distress is a relatively consistent finding in patients with cardiogenic pulmonary edema.

When cardiac disease explains syncope, an arrhythmia often is responsible.

Patients with congenital malformations sometimes develop clinical signs including poor growth (failure to thrive).

60-110

24-50

70-160

160-240

Pulse amplitude is an important characteristic of arterial pulse. The pulse amplitude is determined by pulse pressure (the difference between systolic pressure and diastolic pressure). Pulse pressure depends on stroke volume, aortic distensibility, resistance to flow, end-diastolic volume of arteries, and heart rate.

Weak (hypokinetic) arterial pulse most often reflects a small stroke volume associated with hypovolemia or sometimes (but not usually) heart disease.

Absent arterial pulse may be related to obstruction due to thromboembloism or simply is an "artifact" such as the patient being obese.

Bounding (hyperkinetic) arterial pulse occurs only with PDA. The diastolic run-off throught the PDA contributes to the widening of the the pulse width.

The jugular veins function as manometers. The degree of distension and the height of jugular pulsation reflects right atrial (and right ventricular diastolic) pressure.

It should be evaluated when the patient is standing.

The height of jugular pulsation needs to be >10 cm to suggest right heart failure, volume overload.

Edema under the chin is common in horses with right heart failure.

CRT is not sensitive to acute decreases in CO

Pallor is due to a decrease in oxyhemoglobin. This may be associated with anemia and/or vasoconstriction.

Peripheral cyanosis may be due to lung disease or (rarely) heart defects such as Tetrology of Fallot.

S1: AV valve closure

S1: Atrial contraction

S2: AV valve closure

S2: semilunar valve closure

S3: semilunar valve closure

S3: early diastolic filling

S4: early diastolic filling

S4: atrial contraction

High frequency sound associated with mitral valve prolapse

Common in older, small breed dogs (a precursor of mitral valve regurgitation)

Audibility of S3 and/or S4

In cats (and many dogs), high heart rates mean that the 2 sounds are "summated"

Heard when atrial pressures are high and ventricle is close to its elastic limit.

Velocity is the most important. Acceleration explains almost all murmurs.

Viscosity is the most important. Anemia may explain murmurs when HCT <~17

Diameter is the most important. As blood vessels are dilated or constricted blood flow changes.

Grade 1: a loud murmur with thrill/audible if stethoscope is lifted from chest

Grade 2: loud murmur with an associated thrill

Grade 3: murmur of intermediate intensity

Grade 4: soft murmur

Grade 5: very soft and focal

between S1 and S2

between S2 and S1

Left heart base (aortic/pulmonic areas) 4th, 5th ICS

Left apex (mitral) 6th ICS

Most in cats are heard along the sternal borders

Left heart base and left apex

All of the above

None of the above

Mid-systolic

mid-diastolic

diamond-shaped

associated with outflow tract obstruction

plateau-shaped

associated with AV valves