L9/10: Clinical manifestations and approach to congenital heart diseases

Dr. Santos

What is the #1 most common congenital defect in dogs?

PDA

What is the #1 most common congenital defect in cats?

VSD

What is the #1 most common congenital defect in horses?

VSD

What is the #1 most common congenital defect in cattle?

VSD

What are the volume overload diseases?

PDA, VSD, ASD, TVD/MVD

What are the pressure overload diseases?

SAS, PS

What are the cyanotic (R to L) shunting diseases?

tetralogy of fallot, reverse PDA

What is a systolic mumor?

ejection (SAS/PS) or regurgitant (MVD/TVD, VSD, ASD (usually none)

What is a diastolic murmur?

arterial (valve insufficiency-aortic and pulmonic) and atrioventricular (AV valve stenosis-mitral and tricuspid)

What is a continuous murmur?

“washing machine” murmur never stops- systole and diastole; seen in PDA

Why would a PDA continuous murmur disappear?

pressure equalize between left and right side; BAD

What are examples when you would not here a murmur?

reverse PDA and ASD (similar pressure between atria)

What are the clinical signs associated with PDA?

continuous murmur and bounding (hyperkinetic) femoral pulses

What are the clinical signs associated with reverse PDA?

no murmur with pink oral mucous membranes and cyanotic caudal mucous membranes (red head and blue butt)

What will be seen on bloodwork with cyanotic R to L shunting diseases?

hyperviscosity syndrome (PCV >70%)

What are the different types of ventricular defect?

perimembranous (above-more common) and muscular (below)

What are the clinical signs associated with VSD?

right systolic murmur with normal femoral pulses

What is Eisenmenger’s syndrome?

reverse R to L shunting with VSD and ASD

What are the clinical signs associated with ASD?

often no audible murmur or a soft left basilar systolic murmur with normal femoral pulses

What signalment is common with TVD?

labrador retreiver

What are the clinical signs associated with MVD?

left apical systolic murmur, LCHF

What are the clinical signs associated with TVD?

right systolic murmur, RCHF

What are the clinical signs associated with SAS?

left basilar systolic murmur with weak, slow-rising femoral pulses

Regardless of prognosis, what is the risk with SAS?

development of infectious endocarditis

What are the clinical signs associated with PS?

left basilar systolic murmur with normal femoral pulses

What signalment is common with PS?

french bulldog - anomalous coronary artery

What is the equation used when grading stenosis severity by doppler gradient?

modified bernoulli equation ΔP=4V²

What is the range of ΔP for a mild grade stenosis?

16-50 mmHg

What is the range of ΔP for a moderate grade stenosis?

50-80 mmHg

What is the range of ΔP for a severe grade stenosis?

>80 mmHg

What are the clinical signs associated with ToF?

no murmur at all or left basilar systolic murmur with normal femoral pulses, cyanosis and exercise intolerance

What signalment is common with ToF?

Keeshonds

What chamber is affected with PDA?

LV/LA

What chamber is affected with VSD?

LV/LA

What chamber is affected with ASD?

RV/RA

What chamber is affected with SAS?

LV

What chamber is affected with PS?

RV

What chamber is affected with ToF?

RV