Large Animal Cardiology I- CardioRush

Exercise intolerance
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Terms in this set (91)
Exercise intolerance
What is the most common presenting complaint in horses that request cardiac evaluation?
False (nonspecific sign, can be anything)
True or false: exercise intolerance and poor performance is a specific for CV disease
Dyspnea, collapse
Other than exercise intolerance, what are some other possible presenting complaints for a horse that requests a cardiac exam?
Murmur, arrhythmia, jugular distension, pulse quality, MM color, CRT, peripheral edema
What are characteristics do we evaluate for on a CV PE in a horse?
Anasarca
What is a more dated term for peripheral edema?
True
True or false: Peripheral edema of the ventral torso and limbs is a common manifestation of CHF in large animals
More vertical, changes PMI slightly
How is the heart situated in a horse's chest compared to that of a dog and why is that important?
23-48
What is the normal range for HR in a horse?
Triceps
What muscle is in the way of the bulk of the heart when auscultating?
Soft <2/6 systolic flow murmur
What type of murmur is common in horses?
3/6 or greaterWhat grade systolic flow murmur in a horse would warrant an echo to investigate?Level of elbow (most caudal)Where is the mitral valve PMI in a horse?Craniodorsal of mitralWhere is the aortic valve PMI in a horse?Cranial, slightly lower than aorticWhere is the pulmonic valve PMI in a horse?Right sideWhere is the tricuspid valve PMI in a horse?VSDWhat is the most common congenital heart defect in LA?S1, S2, S3, S4What are the various heart sounds that can be normal in a horse?False (Gallop means pathologic, S3 and S4 sounds aren't necessarily abnormal)True or false: we call an S3 heart sound heard in a horse an S3 gallop, just the same as in small animalsTiming, intensity, PMI, quality or pitchWhat characteristics are cardiac murmurs described with?Holosystolic murmurWhat type of murmur is this?Ejection murmurWhat type of murmur is this?Diastolic murmurWhat type of murmur is this?Continuous murmurWhat type of murmur is this?Innocent murmur, hyperdynamic conditions like fever or anemia, VSD or ASD, aortic or pulmonic stenosisWhat are some causes of ejection quality systolic murmurs?Mitral or tricuspid regurgWhat are some causes of regurgitant quality systolic murmurs?False (Causes ejection quality, but rare in large animals)True or false: Aortic and pulmonic stenosis is a common cause of ejection quality murmurs in large animalsAortic or pulmonic insufficiencyWhat are some causes of diastolic murmurs in large animals?Aortic insufficiencyWhat is the most common cause of diastolic murmurs in large animals?PDA, aortocardiac fistulaWhat are some causes of continuous murmurs in large animals?Grade 1What grade murmur is soft and heard best in a quiet stall or room after intense listening?Grade 2What grade murmur is a soft murmur heard immediately?Grade 3What grade murmur is a low to moderate intensity murmur?Grade 4What grade murmur is moderately intense but not accompanied by a precordial thrill?Grade 5What grade murmur is a loud murmur accompanied by a palpable precordial thrill?Grade 6What grade murmur is a loud murmur with palpable thrill that is audible when the stethoscope is removed from the thorax?Musical, cooing, regurgitant, harsh, crescendo decrescendoWhat are some ways to describe the quality or pitch of a murmur?Base apex leadWhat type of lead is used when obtaining an ECG in horses?R jugular furrow, L chest wallWhat are the attachment points for an ECG in a base apex lead?Rate, rhythmWhat are the only pieces of accurate information obtained on a base apex lead ECG?Category BWhat type of activation activation pattern of the ventricles is present in the horse?Depolarization in single burst, negative QRSHow does category B activation of the ventricles occur in the horse?False (only accurate info from a base apex lead is rate and rhythm)True or false: we can use a base apex lead to determine specific chamber enlargement on the ECGEchoWhat is the best noninvasive technique for looking at the heart in real time in a horse?Prepurchase exam, evaluation of murmurs or arrhythmias, unexplained poor performanceWhat are the indications for performing an echo in a horse?Foals, lateral and DV views can be taken (like in small animal)What age horses are thoracic radiographs most helpful in for diagnosing heart disease and why?Pulmonary edema, pleural effusion, globoid heart with pericarditis or pericardial effusionWhat are some characteristics to look for on a thoracic radiograph that would indicate heart disease?TrueTrue or false: Cardiac troponin I is highly conserved across species and can be used as a biomarker of cardiac injury in horsesMyocardial necrosis, ruptured aortic jet lesion, piroplasmosis, endurance exercise, sepsisWhen will cardiac troponin I increase in horses?Unexplained arrhythmia, exposure to cardiotoxic agentWhat are 2 situations in which you could run a cardiac troponin I assay in horses?AV block, a fib, APCs or VPCsWhat are some common arrhythmias in horses?V tachWhat is a less common arrhythmia in the horse?TrueTrue or false: it is uncommon to see severe ventricular arrhythmias in the horseAV blockWhat is this rhythm?A fibWhat is this rhythm?VPCWhat is this rhythm?V tachWhat is this rhythm?second degreeWhat type of AV block can be normal in horses because they are very athletic?Third degreeWhat type of AV block is never normal, even in athletic animals?Second degree AV blockWhat is this rhythm?Second degree AV blockWhat is this rhythm?Third degree AV blockWhat is this rhythm?Doesn't go away with exercise or anticholinergicsWhen is a second degree AV block in a horse more likely pathologic instead of due to athleticism?No, second degree AV block should resolve with exerciseThe following ECG is taken in a horse that is exercising. Is this normal?Young miniature donkeysWhat equid species has a predisposition for developing third degree AV block?Third degree AV blockWhat is this rhythm?TrueTrue or false: third degree AV block is often seen in young animals, especially miniature donkeys, so it is likely congenitalA fib (irregularly irregular, undulating F waves between complexes)What is the rhythm?False (lone atrial fibrillation is fairly common in horses)True or false: a fib tends to only occur with underlying heart disease in horsesA fibWhat is the most common pathologic arrhythmia in horses?Persistent a fibWhat is term for when a fib does not terminate on its own?PersistentWhat is more common in horses: persistent a fib or paroxysmal?Racehorses, resolves within 24 hours of raceWhat population of horses is more likely to get paroxysmal a fib?False (only true in large horses. In ponies, it is more common to have underlying cardiac disease)True or false: in both large horses and ponies, atrial fibrillation is more commonly seen in the absence of other underlying cardiac diseasesTrueTrue or false: the larger the animal, the more likely lone a fib will developTrigger to start, substrate to maintainWhat 2 things are required for A fib to occur?Concurrent high vagal tone and high SNS tone (such as in cool down period after a race), atrial enlargement, atrial stretchWhat are some predisposing factors for developing a fib?Horses, giant breed dogs, peopleWhat animals are more likely to develop lone a fib?Performance horses with recent onset and no underlying cardiac diseaseIn what horses that develop a fib is conversion indicated?False (may not need to treat horses that aren't high performance athletes, a fib doesn't appear to shorten lifespan)True or false: it is best to always convert a horse with a fib if they don't have underlying heart disease, even if they are not performance animalPrimary cardiac disease presentWhat horses is conversion of a fib not indicated in?Will likely develop again, drugs risky, shouldn't be used for performanceWhy shouldn't you convert horses with a fib that have primary cardiac disease?>60What HR in horses is associated with CHF?QuinidineWhat is the drug of choice for conversion of a fib in horses?NG tubeHow is quinidine given to convert a fib?Negative inotrope, positive chronotrope, hypotensiveWhat are the effects of quinidine on the CV function?DigoxinWhat drug should be given before quinidine for conversion of a fib if tachycardia is present?Increased risk of side effects, no better efficacy with IVWhy is oral quinidine preferred over IV?Amiodarone, flecainideWhat are some treatments other than quinidine for conversion of a fib in horses?TrueTrue or false: amiodarone and flecainide aren't clearly superior to quinidine and work the same way, which is why they aren't commonly usedBiphasic transvenous electrical cardioversionWhat is an option for conversion of a fib in horses if medications don't work?False (requires anesthesia, specialized catheters and equipment)True or false: Electrical cardioversion can be performed in the barn without special equipment