1
Q
What is the key distinction between heart disease and heart failure?
A
Heart disease is the presence of a cardiac abnormality, while heart failure is the clinical manifestation of that disease when the heart can’t meet the body’s needs.
2
Q
Which side of the stethoscope is used to listen for high-frequency heart sounds like S1 and S2?
A
The diaphragm side is used for high-frequency sounds.
3
Q
The bell side of a stethoscope is best suited for listening to what type of heart sounds?
A
Low-frequency heart sounds, such as S3 and S4.
4
Q
What cardiac event produces the S1 heart sound?
A
The closure of the atrioventricular (AV) valves, specifically the mitral and tricuspid valves, at the beginning of systole.
5
Q
The S2 heart sound corresponds to which event in the cardiac cycle?
A
The closure of the semilunar valves (aortic and pulmonary) at the beginning of diastole.
6
Q
What does the presence of an S3 heart sound, occurring in early diastole, often signify?
A
It can be a sign of heart failure, associated with the rapid ventricular filling phase.
7
Q
The S4 heart sound, heard just before S1, is caused by what action?
A
Atrial contraction during late diastole, especially when pushing blood into a stiff or thickened ventricle.
8
Q
A _____ is an auditory vibration of longer duration than normal heart sounds, created by the disruption of laminar blood flow.
A
Murmur
9
Q
According to the American Heart Association classification, what defines Stage A heart disease?
A
The patient is at high risk of developing heart disease but has no identifiable structural abnormalities.
10
Q
In the AHA classification system, what is the key difference between Stage B1 and Stage B2 heart disease?
A
Stage B1 shows no imaging evidence of cardiac remodelling, whereas Stage B2 does show evidence of cardiac remodelling.
11
Q
What defines Stage C heart disease in the AHA classification?
A
The patient has past or current evidence of heart failure, and treatment is necessary.
12
Q
A patient with heart failure that is becoming difficult to manage and is not responding to standard treatment is classified as which AHA stage?
A
Stage D heart disease.
13
Q
What is the primary characteristic of systolic dysfunction in heart failure?
A
Cardiac output (usually stroke volume) is decreased, but diastolic filling of the ventricle is normal.
14
Q
Diastolic dysfunction is characterized by abnormal cardiac _____ with normal _____.
A
Filling
Contractility
15
Q
Forward failure is a term for _____ dysfunction, where ventricles can’t squeeze properly, leading to reduced perfusion.
A
Systolic
16
Q
The clinical progression from ‘dry to wet’ (oedema) is characteristic of which type of heart failure dysfunction?
A
Backward failure, or diastolic dysfunction, due to congestion in the venous system.
17
Q
What are the clinical signs specifically associated with poor cardiac output due to systolic dysfunction?
A
Weak pulses, pale mucous membranes, prolonged CRT, tachycardia, and cold extremities.
18
Q
List the key clinical signs of left-sided congestive heart failure.
A
Pulmonary oedema, adventitial lung sounds, bronchial compression, cough, and cyanosis.
19
Q
What are the primary clinical signs of right-sided congestive heart failure?
A
Ascites, pleural effusion, peripheral oedema, and jugular distention/pulses.
20
Q
What is the Frank-Starling mechanism as a compensatory response to decreased cardiac output?
A
Increased preload leads to increased myocyte stretch, which in turn increases contractility and stroke volume.
21
Q
Activation of the sympathetic nervous system in heart failure has what beneficial effects?
A
It improves cardiac output and helps maintain blood pressure.
22
Q
What are the long-term adverse effects of sympathetic nervous system activation in heart failure?
A
Increased afterload, reduced tissue perfusion, increased myocardial oxygen demand, potential for arrhythmias, and down-regulation of B-receptors.
23
Q
What are the beneficial effects of activating the renin-angiotensin-aldosterone system (RAAS) in early heart failure?
A
It improves cardiac output by increasing preload (Frank-Starling effect) and maintains blood pressure.
24
Q
What are the adverse effects of chronic RAAS activation in heart failure?
A
Increased thirst and water retention leading to congestion, and vasoconstriction which increases afterload and can decrease cardiac output.
25
Which peptide is released from the atria in response to stretch and has natriuretic and diuretic properties?
Atrial natriuretic peptide (ANP).
26
Brain natriuretic peptide (BNP) is released in response to ventricular stretch and can be used as a clinical _____ for heart failure.
Biomarker
27
What is hypovolemic shock?
Shock caused by insufficient blood volume to adequately perfuse tissues, often due to hemorrhage or severe fluid loss.
28
What is the underlying cause of obstructive shock?
A physical obstruction to forward blood flow out of the heart or major vessels, such as a pulmonary embolism or pericardial effusion.
29
Distributive shock is typically caused by a loss of _____ to the blood vessels, leading to widespread vasodilation.
Motor tone (sympathetic innervation)
30
Cardiogenic shock results from an acute, sudden decrease in what?
Cardiac output
31
Which three types of shock are typically vasoconstrictive as a compensatory response?
-Hypovolemic
-obstructive
-cardiogenic shock.
32
Which type of shock is characterized by vasodilation rather than compensatory vasoconstriction?
Distributive (or maldistributive) shock.
33
What is the primary role of the sinoatrial (SA) node in the heart's conduction system?
It is the dominant pacemaker, having the fastest rate of spontaneous action potential generation.
34
What happens if the SA node fails to depolarize?
A lower-order latent pacemaker, like the AV node or Purkinje fibers, will take over at a slower intrinsic rate.
35
In a dog, what is the intrinsic rate of depolarization for the AV node?
40-60 beats per minute.
36
In a dog, what is the intrinsic rate of depolarization for the Purkinje fibers?
20-40 beats per minute.
37
What is meant by 'abnormal automaticity' as a mechanism of arrhythmogenesis?
Damaged myocardial cells that are not normally automatic develop the ability to spontaneously depolarize, causing premature beats or tachyarrhythmias.
38
How does sustained tachycardia reduce cardiac output?
It reduces the time available for ventricular filling during diastole, resulting in a weaker contraction and reduced stroke volume.
39
On an ECG, what does the absence of a QRS complex after a P wave indicate?
An atrioventricular (AV) block.
40
What does the presence of a QRS complex without a preceding P wave suggest on an ECG?
An ectopic complex originating from either a supraventricular or ventricular focus
41
What is sinus arrhythmia?
A regularly irregular rhythm characterized by phasic variation in the P-P interval, often linked to respiration.
42
In a second-degree AV block, what is the characteristic finding on an ECG?
The presence of a P-wave that is not followed by a QRST complex.
43
What is the defining feature of a third-degree AV block?
None of the atrial impulses are conducted to the ventricles, resulting in complete AV dissociation.
44
On an ECG of a patient with a third-degree AV block, what is the relationship between P waves and QRS complexes?
There is no relationship; this is known as AV dissociation.
45
In tachyarrhythmias, what does a normal, narrow QRS complex imply about the origin of the impulse?
It implies a supraventricular origin, as the impulse has traveled through the normal conduction pathway via the AV node.
46
Why are QRS complexes typically wide and bizarre in ventricular tachyarrhythmias?
The impulse originates in the ventricle and spreads slowly from muscle cell to muscle cell, not through the rapid specialized conduction system.
47
A run of three or more consecutive supraventricular premature depolarizations (SVPDs) is defined as what?
Supraventricular tachycardia (SVT).
48
What are the ECG hallmarks of atrial fibrillation?
An irregularly irregular rhythm, no discernible P waves (replaced by fibrillation waves), and usually normal-width QRS complexes.
49
Why can horses develop atrial fibrillation in the absence of underlying heart disease?
Their normally large atrial mass predisposes them to the re-entry circuits that cause atrial fibrillation.
50
What is the term for a single, premature ventricular depolarization?
A premature ventricular contraction (PVC) or ventricular premature complex (VPC).
51
A rhythm where every other beat is a PVC is called ventricular _____.
bigeminy
52
What is the definition of ventricular tachycardia (VT)?
A rhythm consisting of three or more successive premature ventricular contractions (PVCs).
53
What is the critical difference between sustained and non-sustained ventricular tachycardia?
Sustained VT lasts for more than 30 seconds, while non-sustained (paroxysmal) VT lasts for less than 30 seconds.
54
What is the term for the pre-terminal, fatal arrhythmia characterized by chaotic and uncoordinated ventricular electrical activity?
Ventricular fibrillation (VF).
55
Why are cardiac arrhythmias common in dogs with Gastric Dilation and Volvulus (GDV)?
They are often secondary to shock and myocardial ischaemia associated with the condition.
56
What does a first-degree AV block look like on an ECG?
A prolonged PR interval, indicating a delay at the AV node.
57
What is atrial standstill?
An arrhythmia characterized by QRST complexes without P waves, often due to atrial muscle loss and fibrosis or hyperkalaemia.
58
What is sick sinus syndrome?
A degenerative disease of the sinus node causing persistent bradycardia, often with periods of SA block/arrest or paroxysmal tachycardia.
59
What is the typical treatment for a symptomatic third-degree AV block?
Implantation of a permanent pacemaker.
60
What physical maneuvers can be used to treat supraventricular tachycardia by increasing vagal tone?
Ocular pressure or carotid sinus massage.
61
Impaired ventricular contraction with a reduced ejection fraction is a hallmark of _____ dysfunction.
Systolic
62
Features like slowed relaxation and altered passive elastic properties of the ventricle are characteristic of _____ dysfunction.
Diastolic
63
Concentric hypertrophy secondary to conditions like HCM or chronic systemic hypertension primarily causes what type of cardiac dysfunction?
Diastolic dysfunction
64
The neurohormonal compensatory mechanism in heart failure involves the activation of the _____ and the _____ system.
SNS
RAAS
65
In acute hemorrhage, why does the packed cell volume (PCV) not change immediately?
Because whole blood is lost, the loss of red cells and plasma is proportional, so the concentration remains the same initially.
66
Afterload
The pressure or resistance the heart must overcome during contraction to eject blood.
67
What are the two primary pathophysiological mechanisms of cardiac dysfunction?
Impaired pump function (pump failure, conduction disorders) and disturbed haemodynamics (obstruction, regurgitation, shunts, overload).
68
Preload
The volume or stretch on the heart muscle fibers before contraction, analogous to how much a balloon is filled.
69
What type of cardiac overload is caused by increased afterload, such as in aortic valvular stenosis?
Pressure overload
70
What type of cardiac overload is caused by increased preload, such as in mitral valvular regurgitation?
Volume overload
71
List the two intrinsic cardiac compensatory responses to reduced cardiac output.
Dilation and hypertrophy
72
List three systemic compensatory responses to reduced cardiac output.
-Increased heart rate
-Increased peripheral resistance
-Increased blood volume.
73
The _____ mechanism describes how increased preload stretches myofibers, leading to a stronger contraction and increased stroke volume.
Frank-Starling
74
What type of cardiac hypertrophy results from chronic volume overload (increased preload)?
Eccentric hypertrophy
75
What type of cardiac hypertrophy results from chronic pressure overload (increased afterload)?
Concentric hypertrophy.
76
Describe the gross changes in the ventricular wall and lumen in concentric hypertrophy.
The ventricular wall is thickened, and the lumen becomes smaller.
77
Describe the gross changes in the ventricular wall and lumen in eccentric hypertrophy.
The ventricular lumen is dilated, and the wall thickness is normal or thinner.
78
Activation of what system is triggered by decreased renal blood flow in response to low cardiac output?
The Renin-Angiotensin-Aldosterone System (RAAS).
79
What are the two main effects of Angiotensin II in the RAAS response?
Vasoconstriction and aldosterone release.
80
What is the primary function of aldosterone in the context of cardiac compensation?
It causes sodium and water retention by the kidneys to increase blood volume.
81
What is 'forward heart failure' characterized by?
Decreased cardiac output, leading to clinical signs like weakness, lethargy, syncope, and hypotension.
82
What is 'backward heart failure' characterized by?
Blood backing up in the veins behind the failing side of the heart, leading to congestion and oedema.
83
What are the classic clinical signs and pathological findings of left-sided heart failure?
Dyspnoea and cough due to pulmonary congestion and oedema.
84
What are the classic clinical signs of right-sided heart failure?
Systemic venous congestion, leading to jugular distension, ascites, and peripheral oedema.
85
What is the term for right-sided heart failure caused by primary lung disease?
Cor pulmonale.
86
Left-to-right cardiac shunts, such as ASD, VSD, and PDA, primarily cause what type of cardiac overload?
Volume overload
87
In a patent ductus arteriosus (PDA), which chambers of the heart experience volume overload, leading to eccentric hypertrophy?
The left atrium and left ventricle.
88
Which congenital defect is characterized by a continuous 'machinery murmur'?
Patent ductus arteriosus (PDA).
89
Pulmonic stenosis causes pressure overload on which heart chamber, leading to concentric hypertrophy?
The right ventricle
90
Subaortic stenosis causes pressure overload on which heart chamber, leading to concentric hypertrophy?
The left ventricle
91
Newfoundlands are predisposed to which common congenital heart defect?
Subaortic stenosis
92
What is the primary clinical sign associated with a persistent right aortic arch (PRAA) in dogs?
Regurgitation due to megaoesophagus cranial to the heart base.
93
Dysplasia of the tricuspid valve leads to regurgitation, causing volume overload and eccentric hypertrophy of which chambers?
The right atrium and right ventricle.
94
In long-standing left-to-right shunts, what condition can develop that causes the shunt to reverse?
Pulmonary hypertension
95
What is the most common primary heart disease in cats, often heritable in Maine Coons and Ragdolls?
Primary Hypertrophic Cardiomyopathy (HCM).
96
HCM in cats is a form of _____ dysfunction, where the thickened ventricle cannot relax and fill properly.
Diastolic
97
What is a common and serious sequela of feline HCM, resulting from blood stasis in the dilated left atrium?
Thromboembolism, often a saddle thrombus at the aortic bifurcation.
98
What is the most common primary cardiomyopathy in large breed dogs?
Primary Dilated Cardiomyopathy (DCM).
99
DCM is a form of _____ dysfunction, characterized by poor myocardial contraction.
Systolic
100
What nutritional deficiency can cause a secondary dilated cardiomyopathy in cats?
Taurine deficiency
101
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a genetic condition most commonly seen in which dog breed?
Boxers
102
What is the characteristic histological finding in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)?
Myocardial cells, mainly in the right ventricle, are replaced by fatty or fibrofatty tissue.
103
Ionophore toxicity, which is particularly severe in horses, causes myocardial necrosis by inducing an imbalance of which ion within myocytes?
Calcium
104
Deficiency in _____ and/or _____ causes nutritional myopathy (White Muscle Disease) in young ruminants by reducing antioxidant protection.
Selenium
Vitamin E
105
What disease in pigs, caused by Vitamin E/selenium deficiency, is characterized by myocardial necrosis, epicardial haemorrhage, and hydropericardium?
Mulberry heart disease
106
What is the most common cause of endocarditis in domestic animals?
Bacterial infection
107
In cattle, which heart valve is most commonly affected by bacterial endocarditis?
the tricuspid valve
108
In pigs, endocarditis is often caused by which two bacterial genera?
Erysipelothrix
Streprococcus
109
What is the most common acquired heart disease in older, small-breed dogs like the Cavalier King Charles Spaniel?
Myxomatous valvular degeneration (endocardiosis).
110
Myxomatous degeneration most commonly affects which heart valve?
The left atrioventricular (mitral) valve.
111
The pathogenesis of myxomatous valvular degeneration involves mitral regurgitation, which leads to volume overload and _____ hypertrophy of the left ventricle.
Eccentric
112
Heartworm disease (Dirofilaria immitis) in dogs leads to pulmonary hypertension and subsequently, _____-sided heart failure.
right
113
The accumulation of whole blood in the pericardial sac, often leading to cardiac tamponade, is called what?
Hemopericaridum
114
What is the most common primary cardiac neoplasm in dogs, often found in the right atrium and prone to rupture?
Hemangiosarcoma
115
What is the most common metastatic tumor to the heart, especially in cattle?
Lymphoma
116
Aortic body tumors (chemodectomas) are a type of heart-base tumor seen especially in what group of dog breeds?
Brachycephalic breeds.
117
The most common cause of pericarditis in cattle is _____.
Traumatic Reticulopericarditis
118
Vasculitis caused by the deposition of immune complexes in vessel walls is a Type _____ hypersensitivity reaction.
3
119
What disease in pigs os caused by Erysipelothrix rhusiopathiae?
Diamond skin disease.
Results in diamond shaped skin infarcts due to vasculitis and thrombosis
120
The 'wet' or effusive form of Feline Infectious Peritonitis (FIP) is caused by what type of hypersensitivity reaction, leading to immune complex vasculitis?
Type 3
121
The 'dry' or non-effusive form of Feline Infectious Peritonitis (FIP) is characterized by what type of inflammation?
Granulomatous vasculitis.
122
In horses, migration of _____ vulgaris larvae in the cranial mesenteric artery can cause arteritis and thromboembolism, leading to colic.
Strongylus
123
What is the term for inflammation of the umbilical vein in newborn farm animals, which can lead to septicemia and hepatic abscesses?
Omphalophlebitis (Navel ill).
124
A grade 3 systolic heart murmur with maximal intensity at the left apex in an older Cavalier King Charles Spaniel is most suggestive of what condition?
Myxomatous valvular degeneration of the mitral valve.
125
Frothy nasal discharge and severe pulmonary edema in a horse in South Africa are highly suggestive of what viral disease that causes vasculitis?
African horse sickness.
126
In a pig with Mulberry Heart Disease, what is the underlying mechanism of cellular injury that leads to myocardial necrosis?
Oxidative injury due to deficiency of vitamin E and/or selenium.
127
In Australia, which zoonotic virus can cause similar findings of fatal vasculitis and pulmonary edema in horses as African Horse Sickness?
Hendra virus
128
Muffled heart sounds, pyrexia, and signs of pain (arched back) in a dairy cow are classic signs of what condition?
Traumatic reticulopericarditis
129
What is the morphological diagnosis for a heart with the pericardial sac covered in a thick, yellow-white, stringy exudate?
Severe, diffuse, fibrinous pericarditis.
130
On an ECG, the absence of a QRS complex following a P wave is indicative of what type of arrhythmia?
Atrioventricular block
131
What is the term for an AV block where there are more P waves than QRS complexes, but some P waves are still conducted (e.g., 2:1 or 3:1 ratio)?
Second-degree AV block
132
What is the term for an AV block where there is a complete lack of communication between the atria and ventricles (P waves and QRS complexes are independent)?
Third-degree AV block.
133
An ectopic beat that originates from the ventricles and appears wide and bizarre on an ECG is called a _____.
Ventricular premature complex
134
An ECG rhythm that is irregularly irregular with no discernible P waves and a rapid ventricular rate is characteristic of what arrhythmia?
Atrial fibrillation
135
The 'Ascites Syndrome' in rapidly growing broiler chickens is a form of _____-sided heart failure secondary to pulmonary hypertension.
Right
136
Aneurysms and aortic rupture in pigs can be associated with a deficiency of what mineral, which is essential for strong elastic tissue?
Copper
137
What is the most common cause of Thromboembolic Meningoencephalitis (TEM) in cattle, which results in vasculitis and thrombosis in the brain?
Histophilus somni
138
What are 'jet lesions' in the context of cardiac pathology?
Areas of endocardial fibrosis caused by high-velocity, turbulent blood flow hitting the chamber wall, often secondary to valvular stenosis or regurgitation.
139
The classic gross lesion of subaortic stenosis is a _____ or fibrous ring below the aortic valve.
Subvalvular ridge
140
In a ventricular septal defect (VSD), blood shunts from the left ventricle to the right ventricle, causing volume overload primarily in which chamber?
The right ventricle
141
A failure of the _____ to close after birth results in an Atrial Septal Defect (ASD).
Foramen ovale
142
Parvoviral myocarditis (caused by CPV-2) can occur in puppies infected in utero or in the first 15 days of life because the virus targets what type of cells?
Replicating myocardial cells
VET 377
flashcards
Decks in class (28)
# Cards
-
Topic 1- Diagnostic Cytology64
-
Topic 2-Reproduction59
-
Diagnostic Imaging- Reproduction74
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Topic 3- Haematology (L1-4)127
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Topic 3- Haematology L5-659
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Topic 4- Alimentary pt.176
-
Topic 4- Alimentary pt. 2115
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Diagnostic Imaging of the Gastrointestinal Tract62
-
Alimentary Practice Questions163
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Topic 5- Lymphoreticular121
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Topic 5 Electrolytes96
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Topic 6- Endocrine60
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Topic 6- Endocrine pt 290
-
Topic 7- Urinary pt. 1101
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Topic 7- Urinary pt. 285
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Diagnostic Imaging- Urinary Tract64
-
Topic 8-Liver157
-
Topic 8- Gallbladder + Pancreas29
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Diagnostic Imaging- Liver and Pancreas30
-
Topic 9- Respiratory99
-
Topic 10-Cardiovascular System142
-
Topic 10- Cardiovascular System- Pathology51
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Topic 11- Integument75
-
Topic 12- Ear68
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Topic 13- Ocular102
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Topic 14- Neuro69
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Topic 15- Musculoskeletal73
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DI- Musculoskeletal63
