1
Q
Cause of neurocardiogenic syncope
A
Due to profound and abrupt hypotension caused by the combination of bradyarrhythmia and inappropriate reflex vasodilation.
Characterized by sudden autonomic nervous system failure => withdrawal of sympathetic tone with abrupt increase in vagal tone
2
Q
A
3
Q
4 causes of SH?
A
- kidney disease
- increased sympathetic nervous system activation
- endothelial disease
- vascular smooth muscle dysfunction
4
Q
True or false: systemic hypertension is not frequent in canine HAC
A
False
reported in 59-86% of cases
=> more prevalent in dogs with unilateral adrenal tumors
5
Q
A
6
Q
What is the % of reduction in BP in dogs treated with ACEi?
A
10-15% reduction in BP
if moderate or severe BP with TOD => associate with amlodipine
7
Q
Why is amlodipine not recommended as first-line monotherapy for SH in dogs?
A
amlodipine => afferent renal arteriole vasodilation => increases glomerular capillary hydrostatic pressure => exacerbation of proteinuria => damage to the glomerulus
8
Q
What is the name of endosymbiotic bacteria for the transition of microfilariae (L1) of D.immitis to L3 larvae infective into the mosquito?
A
endosymbiotic bacteria Wolbachia + adequate temperature and humidity
9
Q
What is the most frequent lung lobe affected in D.immitis infection?
A
right caudal lung lobe
interstitial inflammation, hemorrhage, fibrosis
(most often caudal lung lobes)
infarction of lung lobe very rare in dogs => due to collateral blood supply of the lungs in dogs
10
Q
What are the roles of Wolbachia in heartworm infection? (3)
A
- promote growth of worm
- promote reproduction of worm
- promote inflammation as early as 2 months after infection and when released at the time of worm death (Wolbachia surface protein in host kidney, liver, lung tissue)
11
Q
What are the effects of doxycycline in the treatment of D.immitis infection? (6)
A
- inhibits hearworm growth
- heartworm death
- promotes sterility in female heartworms
- reduces microfilaria numbers
- reduces inflammation in the host
- pulmonary lesions less severe when doxycycline combined with a macrocyclic lactone preventative
12
Q
What is the cardiac auscultatory abnormality associated with PH and why?
A
- split second heart sound auscultated in the region of left heart base
- due to delayed closure of the pulmonary valve leaflets compared to the closure of the aortic valve leaflets
13
Q
What is the antigen detected from D.immitis?
A
antigen derived from uterus of adult female worm
14
Q
5 Ps in the diagnosis of ATE in cats
A
- palor
- pain
- pulselessness
- poikilothermia (cool limbs)
- paresis/paralysis
15
Q
true or false: cats with ATE at presentation with T<37°C => 50% of chance of survival to discharge
A
true
16
Q
3 treatments for thrombolysis
A
- urokinase
- streptokinase
- exogenous tissue plasminogen activator (alteplase)
-==> risk of bleeding and reperfusion-tissue injury: acidemia, hyperkalemia, kidney injury, hyperphosphatemia, hypocalcemia
17
Q
3 positive prognostic indicators in cats with ATE?
A
- partial limb motion
- one limb affected
- early treatment with antiplatelet drug
18
Q
3 negative prognostic indicators in cats with ATE?
A
- hypothermia at presentation T<37°C
- diagnosis of CHF
- bradycardia
19
Q
true or false: recurrence rate of ATE is low in cats
A
false
25-47% with clopidogrel alone
20
Q
What is the most reliable predictor of ATE in cats?
A
previous episode of ATE
otherwise:
left atrial fractional shortening %
if not available => left atrial enlargement as surrogate
21
Q
MOA of benzopyrones rutin (3)
A
advocated to reduces high-protein lymphedema by:
- stimulating macrophages
- promoting proteolysis
- enhancing absorption of protein fragments
22
Q
Most frequent location of HSA of the heart?
A
Right atrium
23
Q
% of concurrent splenic HSA with heart HSA
A
30%
24
Q
true or false: spontaneous resolution of idiopathic pericarditis after pericardiocentesis is rare
A
false
in 50% of cases
25
2 causes of metabolic pericardial effusion?
- secondary to uremia
- cholesterol-based pericardial effusion associated with hpothyroidism
26
What are the 2 most common tumor of heart base in dogs?
- neuroendocrine tumors (40%)
- thyroid adenocarcinoma (25%)
27
Best echocardiographic view to diagnose RA mass?
left cranial parasternal long-axis view
28
What is the most important treatment in dogs with heart base tumor and pericardial effusion ?
partial pericardectomy => improve MST
29
Diagnosis of constrictive pericarditis?
Right heart catheterization
30
31
What are the 2 breeds of cats more commonly presenting OHCM phenotype?
chartreux
persian
32
Ocular csq of taurine deficiency?
central retinal degeneration
33
Normal VHS in a cat?
<8 vertebrae
34
Roles of measurement of plasma cardiac troponin I for feline cardiomyopathies ? (3)
- reflect HCM severity
- predictor of cardiac death: cutoff>0.7 ng/mL ; independently of CHF or LAE
- discrimination between healthy cats and cats iwith HCM: cutoff>0.06 ng/mL Se= 92%, Sp= 95%
35
Why does N-terminal pro-B-type natriuretic peptide increase?
increase in response to myocardial wall stress
36
Utility of NT-proBNP in cats ?
- in a cat with respiratory distress, differentiate CHF from IRY respiratory dz, 90% diagnostic accuracy
=> can be measured in pleural fluid samples => differentiate non-cardiac pleural effusion from cardiac pleural effusion with Se=100%, Sp= 77%
- discriminate healthy cats from cats with moderate to severe occult heart dz: Se= 100%, Sp= 71%, cutoff>99 pmol/L
==> not normal from those with mild occult heart dz
37
What are the criteria for a cat with ACVIM stage B2 to be at risk for ATE? (and prescribe antithrombotic therapy) (4)
- spontaneous echoconstrast
- moderate to servere LAE
- low LA FS%
- low LA appendage velocities
38
2 potential deleterious effects of the use of atenolol in HCM cats
- decrease LA function
- decrease flow velocity in the left auricle of healthy cats
- ==> risk factors for LAE and ATE
potential benefit but not proven: decreases myocardial ischemia
==> beta 1 selective beta blocker => negative chronotropic and inotropic effects => prolongation of diastolic phase and reduced LVOTO
39
3 potential treatments for ACVIM stage B HCM in cats?
- diet reduced in starch and supplemented with omega-3 fatty acids => significant decrease in end-diastolic IVS and LVFW thickness with decreased cTnI and IGF-1
- calcium channel blocker diltiazem (except severe LVOTO and/or ventricular arryhtm)=> negative chronotropic and ionotropic effects + direct effects on LV relaxation + coronary vasodilation + antiarrhythmic properties => no proof
- ACEi => ATII and aldosterone induce myocardial fibrosis and hypertropy + vasodilatory effects => no proof
40
What is the main pathophysiologic characteristic of HCM and RCM?
diastolic dysfunction (as pericardial effusion)
but contrary to DCM
41
One AE of spironolactone in cats?
ulcerative facial dermatitis
42
What is the undesirable effect of sotalol in the treatment of ventricular tachycardia in cats with DCM?
negative inotropic effect
43
What is the concurrent condition which increase toxocity of digoxin?
hypokalemia
44
Non-genetic causes of DCM in dogs?
- nutritional deficiencies: taurine, carnitine, low-protein diet
- Toxins/drugs: doxorubicin, moensin
- Chronic manifestation of myocarditis (infectious, inflammatory)
45
What are the 2 most common arrythmias diagnosed with DCM in dogs?
in 89% of cases there are arrythmias associated with DCM
- ventricular arrythmias
- atrial fibrillation
46
When is the measurement of plasma/serum taurine recommended in face of canine DCM?
- For specific breeds: Cocker Spaniel, Retriever or atypic breed for DCM
- History of eating lamb-based diet, vegetarian diet, low-protein diet or non-traditional diet
47
Why is ACEi indicated in DCM dogs (preclinical and clinical)?
because of anti-myocardial remodeling effects
48
Antiarrhythmics recommended for canine DCM with ventricular arrhythmias? (3)
sotalol, mexiletine, amiodarone (combination also possible)
## Footnote
for significant VA: frequent premature ventricular complexes with high complexity or rate: couplets, triplets, ventricular tachydardia; HR > 180 BPM
49
Which is the antiarrhythmic drug not contraindicated in the case of ventricular arryhthmia ?
digoxin
50
Link taurine deficiency and DCM?
taurine important for cardiac contractility
51
What is the most common arrhythmia identified in ARVC?
ventricular arrhythmia of RV origin: left bundle branch block morphology
52
True or false: ventricular dysfunction and RV dilatation are frequent in Boxers with ARVC
false
systolic dysfunction <10% of boxers
=> more frequent in English Bulldogs
53
3 main causes of ventricular arrhythmias in dogs
- DCM
- pericardial effusion
- cardiac neoplasia
54
Causes of myocarditis in dogs
- viral: parvovirus, CDV
- protozoal: trypanosomiasis, leishmaniasis, toxoplasmosis, neosporosis
- bacterial: leptospirosis, bartonellosis, borreliosis, ehrlichiosis
- fungal: blastomycosis, coccidioidomycosis
- immune-mediated
- traumatic
- non-specific inflammatory disorders
55
2 most common arrhythmias associated with myocarditis
- ventricular arrhythmias
- atrioventricular block
56
More common abnormalities on ECG associated with atrial myopathy?
atrial standstill with an escape rhythm
57
Differentials for aortic regurgitation (5)
- infective endocarditis
- congenital aortic stenosis
- myxomatous lesions
- severe systemic hypertension
- bi or quadricuspid aortic valve
58
True or false: arrhythmias are uncommon in infective endocarditis
false
in 50-75% of cases
59
true or false: thrombocytopenia is frequent in infective endocarditis
true
50% of cases
60
Modified duke criteria in dogs: major (2)
- positive echocardiographic findings: vegetative lesion, destructive lesion, abscess, new valvular insufficiency, greater than mild aortic regurgitation in the absence of another cause (subaortic stenosis, congenital aortic valvular malformation, severe SH, annuloaortic ectasia)
- positive blood cultures: >= 2 positive cultures of orgsm consistent with IE; >=3 positivecultures of common skin contaminants
61
Modified Duke criteria in cats: major (3)
- positive echocardiographic findings: vegetative lesion, destructive lesion, abscess, new valvular insufficiency
- positive blood cltures: >/=2 cultures of orgsm consistent with IE; >/= 3 positive cultures of common skin contaminants
- response to therapy against Bartonella: resolution of clinical signs and echocardiographic changes+ decrease of serological titers and/or negative PCR and/or negative BAPGM enrichment blood culture following appropriate TT
62
Modified Duke critera in dogs: minor criteria (13)
- fevere
- medium to large breed dog (>15 kg)
- subaortic stenosis
- vascular phenomena: aterial emboli, septic pulmonary infarcts, intracranial hemorrhage
- immunological phenomena: GN, PA, vasculitis
- Bartonella-positive PCR and/or titer > 1:1024
- positive blood culture nor meeting major criteria
- new and/or worsening heart murmur
- chronic indwelling catheter
- immunocompromised state
- predisposing heart conditions (other than SAS)
- repeated non-sterile IV drug administration
- echocardiogram consistent with IE but not meeting the major criteria
63
Modified Duke critera in dogs: minor criteria (5)
-fever
-vascular phenomena: arterial emboli, septic pulmonary infarct, intracranial hemorrhage
- immunological phenomena: GN, PA, vasculitis
- presence of greater than mild aortic or mitral insufficiency of unknown chronicity in the absence of primary myocardial dz
- presence of microbial evidence: positive culture not meeting major criteria, sepsis
64
in the context of congenital cardiac dz, on radiographs, dilation of the main pulmonary artery suggestive of which diz?
- PH
- left-to-right shunt
- pulmonic stenosis
65
in the context of congenital cardiac dz, on radiographs, dilation of the aorta suggestive of which diz?
- aortopathies
- PDA
- subaortic stenosis
66
What is the test used to confirm or ruled out a right-to-left shunting?
saline contrast echocardiography
67
Which is the congenital heart dz characterized more frequently with continuous heart murmur craniodorsally at the left heart base with hyperkinetic pulse ?
PDA in dogs
68
what is the more characteristic sign of PDA on thoracic rx?
aortic bulge caused by abrupt narrowing of the descending aorta
other findings: left heart enlargement, pulmonary overcirculation in proportion to the magnitude of the left-to-right shunt
69
typical murmur of left-to-right murmur?
soft, grade, 2-3/6 systolic ejection murmur over the left heart base and splitting 2d heart sound
70
heart murmur with a typical small, membranous VSD?
holosystolic murmur heard best over the right, ventral, mid-to cranial precordium
## Footnote
if subarterial VSD defect opens just under the pulmonic valve => systolic murmur heard best at the left heart base
if distortion of the aortic root causing substantial AR => to and fro murmur (decrescendo diastolic murmur) can be confused with PDA
71
What is an Ebstein's anomaly?
tricuspid dysplasia (congenital): displacement of tricuspid leaflet apically in the RV
72
ECG common findings in animals with tricuspid dysplasia?
splintered QRS morphology
73
Which is the finding typically observed with AV dysplasia on ECG?
Tall or wide P waves
74
Supravalvular pulmonic stenosis is uncommon, except in which breed of dogs?
French Bulldog
75
In which disease, pulsus parvus et tardus is described?
subaortic stenosis => because of obstruction => rate of LV ejection is delayed => diminished and late-rising arterial pulse
76
Heart murmur of subaortic stenosis can be heard in which particular region of the body?
ventral cervical region (carotid arteries)
77
depression of the ST segment?
myocardial ischemia
78
increased R wave indicates ?
LV hypertrophy
79
Anatomic characteristic of Tetralogy of Fallot
1/ perimembranous VSD (typically large)
2/ Dextroaorta (rightward-positioned aorta)
3/ RV outlflow obstruction due to infundibular obstruction ,IIRy RV hypertrophy (pulmonary valve often hypoplastic)
## Footnote
Breed predisposed: Keeshond, English Bulldog
80
true or false: cor triatriatum dexter occurs mainly in dogs and cor triatriatum sinister occurs mainly in cats
true
ECVIM 2026
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