propedeutics small animals- circulatory system exploration

dogs

PDA is a genetic defect that occurs more commonly in what species?

cats

interatrial septal defects will more commonly affect what species?

dilation of the heart ventricles, and lessened ability to contract

what is dilated cardiomyopathy?

doberman, boxer, shepherd

in what dog breeds is dilated cardiomyopathy (DCM) more common?

thickened ventricle walls

what is hypertrophic cardiomyopthy (HCM)?

persians, maine coon, british shorthair, sphynx

what cat breeds commonly suffer from hypertrophic cardiomyopthy (HCM)?

chihuahuas, cocker spaniels

what dog breeds are more commonly suffering from PDA?

hypertrophic cardiomyopathy

do cats suffer more commonly from dilated cardiomyopathy or hypertrophic cardiomyopathy?

dilated cardiomyopathy

do dogs suffer more commonly from dilated cardiomyopathy or hypertrophic cardiomyopathy?

small breeds

do small or large breeds suffer more often from mitral regurgitation?

degenerative (endocardiosis)

old animals commonly suffer from _______valve disease

females

is PDA more prevalent in males or females?

-exercise intolerance

-dyspnea/cough

-edema (pulmonary or subcutaneous)

-ascites

-syncope

-tiredness/lethargy

-anorexia

what are the main signs of circulatory problems?

trouble breathing

what is dyspnea?

aortic valve

subcutaneous edema could be a sign that what part of the circulatory system has failed?

pulmonary valve (of the left heart)

pulmonary edema could be a sign that what part of the circulatory system has failed?

subcutaneous edema

when the aortic valve fails, what type of edema do we see?

pulmonary edema

when the aortic valve fails, what problem in the respiratory tract do we have?

fainting

what is syncope?

ascites

what is the medical term for free fluid in the abdomen?

1. general physical appearance

2. ocular exam

3. mouth exam- mucous membranes and CTR

4. respiratory effort

what inspections are involved in the general inspection for the circulatory system?

under normal conditions in a horse,

in cats and dogs, this is pathological

should we feel the pulse in the jugular vein?

loss

do cardiomyopathies usually cause weight loss or gain?

right heart failure

if we feel a pulse in the jugular vein in a dog or a cat, what is the issue?

depressed and lethargic

what is the attitude of an animal with a cardiomyopathy?

growth retardation

congenital pathologies cause what physical difference?

hydrostatic pressure increase, due to heart failure

what is peripheral edema?

heart failure

what causes peripheral edema?

passive- cold and painless

inflammatory- hot and painful

what are the 2 types of peripheral edema? what is the difference?

left heart failure- may have pulmonary edema as well, so need to auscultate

an animal with nasal discharge, dyspnea, and cough may have what cardiac issue?

right heart failure

what can you suppose an animal with ascites has wrong?

retinal hemorrhage, retinal vessel enlargement

arterial hypertension may cause what ocular affects?

arterial hypertension

ocular signs, such as retinal hemorrhage or retinal vessel enlargement may indicate what circulatory problem?

anemia

if the animal has very pale mucous membranes, we can assume it has this problem:

hyperemic mucosa

dark red mucosa is called....

hyperemic mucosa- dark red color

polycythemia causes what change in the mucous membranes of the animal?

blue,

PDA, due to lack of deliverance of oxygen

cyonotic mucosa appears what color? what disease is a possible cause and why?

cyanotic mucosa

what is this change of color of the mucosa called?

lack of oxygen- can be caused by PDA

what is the problem that causes cyanotic mucosa?

because they are usually stressed out at the vet, so will commonly pant,

sometimes we ask the owner to video at home to accurately record the breathing pattern

why is it sometimes difficult to examine the respiratory effort of the animal?

place hands behind the armpits at the sternal border

how/where can we manually feel the heartbeat?

yes

is it normal to feel the heartbeat with your hands?

pathological: the heart rotates, striking the chest wall in the ventricular systole

what is an apex beat?

pathological,

only physiological in greyhounds or animals that perform intense exercise

is an apex beat physiological or pathological?

the heart beat

what are we feeling here?

a palpable vibration of the thoracic wall from the heart- it is a consequence of the passage of the blood from laminar to turbulent regime (from smooth flow to an irregular, chaotic flow)

what is cardiac fremitus?

pathological always

is cardiac fremitus physiological or pathological?

femoral artery

what vessel in dogs and cats is the more useful to detect the pulse?

arteries

do we use veins or arteries to feel the pulse?

strong, regular/constant, equal intensity and amplitude, symmetrical (in both femoral arteries), synchronous (should match with heart beat)

what should a normal pulse feel like?

number or beats/ventricular contractions per minute

what is pulse rate/frequency?

60-160 bpm

what is the normal pulse of a dog?

130-230 bpm

what is the normal pulse of a cat?

-heart weakness (hyposystole)

-poor blood flow to the heart (hemorrhage, clot, hemodynamic collapse)

what might a weak pulse indicate?

lungs

what part of the animal do we auscultate first?

-access the intensity of heart tones

-determine heart rate

-asses the presence of murmurs

-assess rhythmicity

what are the objectives of ausculation?

tricuspid valve

what valves do we auscultate on the right side?

mitral, pulmonary, aortic valve

what valves do we auscultate on the left side?

left

if we want to listen to the mitral valve, on what side do we auscultate?

right

if we want to listen to the tricuspid valve, on what side do we auscultate?

left

if we want to listen to the pulmonary valve, on what side do we auscultate?

left

if we want to listen to the aortic valve, on what side do we auscultate?

left 3rd

which intercostal space do we auscultate to listen to the pulmonary valve?

left 4th

which intercostal space do we auscultate to listen to the aortic valve?

left 5th

which intercostal space do we auscultate to listen to the mitral valve?

right 4th

which intercostal space do we auscultate to listen to the tricuspid valve?

2 sounds and 2 silences- lup-dupp

what sounds consist one cardiac cycle?

S1

which sound of the heart beat should be louder- S1 or S2?

mitral and tricuspid valves

S1 is the sound produced by the closure of the _______

pulmonary and aortic valves

S2 is the sound produced by the closure of the _______

S2 to S1

is the silence longer between S1 to S2 or between S2 to S1?

-physical effort

-thinning of the rib wall

-tachycardia

-fever

-cardiac hypertrophy (more common in cats)

-anemia

what might cause an increased heart beat intensity?

increases the intensity

how does anemia affect the intensity of the heart beat?

increase

if the animal has a thin rib wall, how does this affect the heart beat intensity?

more intense

an animal with a fever will have a more or less intense heart beat?

makes it more intense

how does cardiac hypertrophy affect the intensity of the heart beat?

-heart and circulatory weakness

-pericardial/pleural effusion (accumulation of liquid)

-obesity

-pneumothorax (air in thoracic cavity)

-subcutaneous edema

when auscultating an animal's thorax, we notice a very soft, less intense heart beat. what pathological issues may be the cause?

pneumothorax

what is the medical term for pathological air in the thoracic cavity?

decreases the intensity

how does accumulated fluid or air (ex- pericardial/pleural effusion, pneumothorax, subcutaneous edema) affect the intensity of the heart beat?

-heart failure

-infections

-drugs

-fever

-poisonings

-anemia

what are possible causes of tachycardia?

-certain poisonings

-drugs

-fasting periods

-hepatic or endocrine disease

what can cause bradycardia?

prolonged vibration that is produced by turbulent blood flow

what is a murmur?

organic murmurs are caused by heart disease, while functional murmurs are due to physiological conditions outside of the heart

what is the difference between and organic and functional murmur?

organic, because it indicates a heart disease

which is a worse prognosis- organic or functional murmurs?

endocarditis, valvular lesions, tumors, or parasitic nodules

what are possible causes of organic murmurs?

-physical efforts

-cardiac dilation

-loss of blood viscosity

-fever

-young puppies might have this- it is normal and disappears

a functional murmur might be caused by...

cardiac dilations due to an excess of exercise

more common in dogs

what is athletes heart and what species commonly has it?

the blood has to speed up through stenotic (narrow) valves, causing a vibration

what is a flow murmur?

the blood backs up through a poorly closed valve (valve insufficiency)

what is a reflux murmur?

flow

which, flow or reflux murmur, do we hear before the heart beat?

reflux

which, flow or reflux murmur, do we hear after the heart beat?

flow

which type of murmur- flow or reflux- is caused by a valve that is too narrow, so the blood must be pushed through faster, which causes vibrations?

reflux murmur

which type of murmur is this- flow or reflux:

when auscultation a dog's heart, we notice a murmur that occurs immediately after we hear the hear beat. when performing further exams, we notice that this is because the mitral valve has difficulty closing all the way, so blood goes backwards through it.

continuous murmur

what type of murmur is caused by PDA?

on a scale of 1 to 6.

1- very mild

2- mild

3- medium

4-strong without thrill

5-strong with thrill, can feel vibration

6-very loud and palpable

how do we grade murmurs?

6

which is the murmur with the worst prognosis- grade 1 or grade 6?

it has lost its smoothness, commonly due to pericardial membrane inflammation

why would we hear pericardial rubbing?

red- right axila

yellow- left axila

black- right hindlimb

green- left hindlimb

what are the colors of the forceps and their position on the dog for an ECG?

An electrocardiogram (ECG)

what is being performed?

right hindlimb

for an ECG, where do we place the black forcep?