Heart

Question 1

How many cusps does an AV valve have and how many does an aortic and pulmonic valve have?

Answer 1

AV - 3

PV, AV - 2

Question 2

What are the 2 layers of pericardium?

Answer 2

Fibrous (outer) and serous (inner)

Question 3

Which arteries supply, which veins drain the heart?

Answer 3

Coronary

Question 4

What are these called?

Answer 4

Question 5

Which of the following are associated with Kartagener’s syndrome?

A) Dextroversion
B) Dextrocardia with situs inversus
C) Dextroversion with situs inversus
D) Dextroposition with situs inversus

Answer 5

B) Dextrocardia with situs inversus

Question 6

Dextrocardia is associated with which syndrome and conditions?

Answer 6

Kartagener’s syndrome, bronchiectasis, recurrent sinusitis

Question 7

What is Kartagener’s syndrome?

Answer 7

It is a combination of situs inversus and primary ciliary dyskinesia, which leads to chronic sinusitis (due to lack of normal mucus clearance) and bronchiectasis.

Question 8

_____ percentage of cats over _____ years old have a cranially sloping cardiac silhouette, with increased sternal contact, on a lateral radiograph.
____ of cats over ____ years have a redundant/tortuous aorta.

Answer 8

40% of cats over 10y

28% of cats over 10y

Question 9

The heart is magnified in a VD/DV (choose one) radiograph.

Answer 9

VD, as it’s further from the detector

Question 10

Max size (in intercostal spaces) of dog and cat hearts on lateral radiographs?

Answer 10

Dogs: 2.5 - 3.5

Cats <2.5

Question 11

Approx. normal VHS in dogs

Answer 11

8.5 - 10.5

Question 12

Normal VLAS in dogs

Answer 12

1.4 - 2.2

Question 13

Arrow points to?

Answer 13

Pericardial fat stripe sign

Question 14

Which CVC:Ao is suggestive of R-CHF?

Answer 14

> 1.5

Question 15

Where does the thoracic duct usually empty

Answer 15

CrVC

Question 16

On a lateral thoracic radiograph, which pulmonary artery is more dorsal - left or right?

Answer 16

Left

Question 17

In which lateral projection are the cranial lobar arteries best differentiated?

Answer 17

Left lateral

Question 18

What is the hallmark radiographic/US sign of a persistent left cranial vena cava?

Answer 18

Dilated coronary sinus

Question 19

What are these images showing?

Answer 19

A persistent left cranial vena cava

Question 20

Which syndrome should be suspected here?

Answer 20

Marfan

Question 21

DCM has impaired systolic/diastolic function?

Answer 21

Systolic

Question 22

What are some types of secondary DCM? i.e. what can cause DCM

Answer 22

• Tachycardia induced
• Taurine deficiency, also grain-free diets
• Myocarditis

Question 23

What did the PROTECT study about DCM in Dobermanns report, regarding timing of diagnosis and outcome?

Answer 23

Early diagnosis can extend lifespan because treatment delays onset of CHF, as they otherwise present in CHF

Question 24

What should be ruled out with an enlarged heart and predominantly signs of R-CHF?

Answer 24

Pericardial effusion, because DCM usually presents with L-CHF

Question 25

DCM usually progresses into L or R CHF?

Answer 25

Left

Question 26

What is ARVC an which breed is mostly predisposed?

Answer 26

Arrhythmogenic right ventricular cardiomyopathy, Boxers (bulldogs also)

Question 27

Which part of the heart is primarily involved with feline HCM?

Answer 27

concentric hypertrophy of the LV > diastolic dysfunction > LA enlargenent

Question 28

Which condition looks very similar to feline HCM?

Answer 28

TMT

Question 29

Pulmonary hypertension may be secondary to left-sided heart failure in the cat - true or false?

Answer 29

True, this is why you should assess pulmonary arteries in cats with L-CHF pulmonary edema, and also why both arteries and veins can be enlarged and therefore similar in diameter.

Question 30

How does the 'valentine heart' shape in cats happen?

Answer 30

LA enlargement +/- RA, although RA enlargement can be misinterpreted on radiographs, as it us usually just a mass effect from a large LA.

Question 31

In an Abyssinian cat with this thorax, what should be considered?

Answer 31

DCM

Question 32

What kind of cardiomyopathy can develop from hypothyroidism in dogs?

Answer 32

DCM

Question 35

Which hormonal imbalance can cause DCM in dogs?

Answer 35

Hypothyroidism

Question 35

what are the most common causes of pericardial effusion in dogs and cats?

Answer 35

Dogs - equally idiopathic and neoplastic Cats - biventricular CHF Other causes: LA tear, septic pericarditis, trauma, coagulopathy, hypoalbuminemia, uremia, SIRS; in cats: FIP, lymphoma

Question 36

Pericardial effusion accumulates between which structures?

Answer 36

Heart and parietal pericardium

Question 37

Why does pericardial effusion have such distinct cardiac margins on radiographs?

Answer 37

There is no movement blur (systolic/diastolic dysfunction).

Question 38

What is the most common cardiac neoplasia and where does it occur most commonly?

Answer 38

hemangiosarcoma, right auricle or right AV groove

Question 39

Where are cardiac myxomas usually located?

Answer 39

LA or RA

Question 40

How does a traumatic diaphragmatic rupture/tear differ from a PPDH?

Answer 40

Traumatic ones don't (usually) involve the pericardium.

Question 41

Which hemodynamic change could occur from a pericardial cyst?

Answer 41

R-CHF, compresses and causes decreased diastolic function

Question 42

Which part of the heart is most frequently reported to herniate through pericardial defects?

Answer 42

RAA

Question 43

What is this showing?

Answer 43

Suspected LAA herniation (through a pericardial defect)

Question 44

Which worm is the cause of heartworm and what is the vector?

Answer 44

Dirofilaria immitis, mosquito

Question 45

Where does D.immitis live?

Answer 45

Pulmonary arteries +/- RV

Question 46

Which parasite could cause this in a dog?

Answer 46

Heartworm (dirofilaria immitis), massive pulmonary trunk, huge and tortuous pulmonary arteries

Question 47

Which cut-off ratio (pulmonary artery measurement) in cats with heartworm indicates pulmonary hypertension?

Answer 47

>1.6x 9th rib

Question 48

Which parasitic condition could you consider in a cat with this appearance?

Answer 48

Heartworm (Dirofilaria immitis), dilated pulmonary arteries - the worms live there

Question 49

Which parasite could you find in the R heart, or pulmonary arteries nearer to the R heart - Angiostrongylus or Dirofilaria?

Answer 49

Dirofilaria immitis (aka heartworm), these guys are huge 15-25cm Angiostrongylus vasorum (aka lungworm) is much smaller (<2cm) and lives only in the periphery. They can still cause pulmonary hypertension though.

Question 50

Which other congenital anomalies can occur in concurrence with PPDH in cats?

Answer 50

Midline defects: umbilical hernia, pectus excavatum, pericardial defects

Question 51

Which parasite (D. immitis or A. vasorum) is likelier to show wider pulmonary arteries?

Answer 51

D. immitis; A. vasorum are small and the lung changes (bronchial with multifocal peripheral alveolar) are usually just associated with the reaction to the worms, e.g. inflammation from eggs and migrating larvae, coagulopathy.

Question 52

What time frame is expected for an alveolar pattern to resolve after treatment of lungworm?

Answer 52

more than a month

Question 53

If you inject agitated saline into a peripheral vein in a normal dog, where should it appear in the heart? Where should it not appear, and what does it suggest if it does appear there?

Answer 53

Normal - appears in the R heart (via CVC, etc.), and the bubbles are too big to cross the pulmonary capillaries, so wouldn't be seen coming back into the L heart. If they appear in the L heart though, they must have crossed earlier than the capillaries, i.e. there must be a shunt. One example would be foramen ovale (RA to LA; this would be immediate), or if it's slightly later, it could be a pulmonary arterivenous shunt/anastomosis (large enough to pass the bubbles).