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31 Cards in this Set
- Front
- Back
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How do you diagnose endocarditis |
By a combination of appropriate clinical signs (fever, heart murmur, leukocytosis, heart failure, embolic signs like renal infarction) plus echo signs plus bacterial culture findings |
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Treatment for endocarditis |
Antibiotics ideally based on C&S which must be bacteriocidal as the bacteria grow in the vegetation so bacteriostatic will not sterilize the vegetation |
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Prognosis for endocarditis |
Poor |
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What kind of heart failure gets pleural effusion |
In dogs is more commonly RHS CHF. In cats it can be either side, and actually seems to be more L than RHS |
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What is systolic dysfunction |
Failure of cardiac contractility or reduced left ventricular outflow |
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What is the causes of reduced cardiac conractility causing systolic dysfunction |
DCM is most common Sepsis associated myocardial dysfunction Endomyocarditis in cats, a rare condition occurring several days after a routine procedure eg neutering Myocardial infarction (rare) |
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What are the causes of systolic dysfuction by reduced LV outflow |
Aortic stenosis Chordae tendinae rupture causing severe acute retrograde blood flow |
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What is diastolic heart failure |
Inadequate ventricular filling |
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Name 4 causes of diastolic failure |
Hypovolaemia Tamponade Myocardium unable to relax = HCM Inadequate time to fill (tachycardia) |
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In cats should you be looking for a murmur or a gallop rhythm with heart disease |
You should look for both, but a gallop more specifically identifies heart disease than does a murmur. A gallop is usually signifying diminished ventricular compliance in conjunction with high atrial pressures |
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Name 2 drugs reducing preload |
Furosemide Nitroglycerin |
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What is the action of nitroglycerin |
Venodilation as well as dilation of specific arteriolar trees including those of hte cardiac circulation |
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When is nitroglycerin used |
As adjunctive treatment to reduce preload in conjunction with furosemide |
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How is nitroglycerin given |
Transdermally |
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Name 2 drug used to reduce afterload acutely |
Sodium nitroprusside Ace inhibitors |
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What is the action of sodium nitropruside |
Very potent arterial and venous dilator to reduce blood pressure - works by metabolism of NP to cyanide and NO, which is a potenti vasodilator |
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When is sodium nitroprusside used |
Short term management of hypertensive crisis |
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What are the precautions you need to take when using sodium nitroprusside |
Cancause hypotension - only use with continuous BP monitoring. can cause cyanide toxicity especially if ued over 24 hours, or in conjunction with renal or liver failure |
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Name 3 positive inotropes |
Doutamine Dopamine Pimobendan |
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How do dobutamine and dopamine work |
beta agonists especially beta 1, so positive inotrope plus also causes some vasodilation (watch for BP) |
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What is the tricky thing with dopamine/dobutamine dosing |
Dopamine (not dobutamine) at low dose is a positive inotrope and vasodilator, but at high dose causes vasoconstriction |
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How doe ace inhibitors work in cardiovascular disease |
Inhibitor production of ATII which is a vasoconstrictor therefore vasodilation ocurs. Also ATII stimulates sodium retnetion therefore ACEI also reduce water rention and reduce volume so reduce pre and afterload. |
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Do ACEIs work better in cats or dogs |
Are more reliable in dogs |
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Why do DCM dogs have a murmur |
Is often secondary to valve problems which are secondary to the DCM |
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Of the 3 main heart diseases, which is the most useful to ECG |
DCM |
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Treatments to consider for DCM - 7 |
1. Reduce stress increase rest 2. Centesis for pleural effusion 3. Oxygen 4. Furosemide 12-3 hours 5. NG 6. Arrhythmia treatment if needed 7. Sodium nitrorusside or dobutamine |
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How rapidly should one reduce blood pressure and why |
Immediate reduction by maximum 25% then decrease to 160/110 in the next 2-6 hours. Dropping BP faster than this can precipitate renal, cerebral or coronary ischaemia |
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What are the two treatments you can use for rapid reductions in BP |
Sodium nitroprusside CRI Enalaprilat (a fast acting cousin of enalapril) |
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What arrhythmias can respond to cardioversion |
VT and SVT. Not VF, not very irregular and rapid polymorphic VT |
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When is cardioversion indicated |
For prompt termination of an arrhythmi causing ahemodynamic instability and when antiarrhythmic drugs have failed |
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Mono v biphasic defibrillation |
Monophasic defibrillators generate a unidirectional flow of current through the heart. Biphasic has a positive current then negative flow in the opposite direction. These are more effective in terminating VF as the second wave eliminates charges only partially depolarised by the first shock. |
