Transcript DISEASES OF THE CARDIOVASCULAR SYSTEM

What’s your purpose?
“It may be that your sole purpose in life is
simply to serve as a warning to others.” 
-Anonymous
DISEASES OF THE
CARDIOVASCULAR SYSTEM:
Cardiomyopathies
CHF
Valvular disease
Cogenital malformation
Infectious
CONGENITAL DEFECTS: PULMONIC
STENOSIS
Chihuahuas, English Bulldogs, are commonly affected. CAUSE: ___________________
> 1 year
PULMONIC STENOSIS
In pulmonic stenosis, the _______________________ is narrowed,
either at the valve itself, just below it, or just after it.
PULMONIC STENOSIS
The most common form of pulmonic stenosis involves
a deformed pulmonary valve such that the valve leaflets
____________ , the ___________________ , or the valve cusps
are fused.
The heart must pump extra hard to get blood through
This unusually narrow, stiff valve.
The __________________ becomes thickened from all this extra work.
The right atrium May become dilated and hypertrophied.
CONGENITAL DEFECTS: PULMONIC
STENOSIS
NORMAL CANINE CHEST RADS
THIS DOG HAS PULMONIC STENOSIS –
THE HEART LOOKS “______________”
IN THE
FRONT DUE TO RIGHT VENTRICULAR
ENLARGEMENT
CONGENITAL DEFECTS: PULMONIC
STENOSIS
• CLINICAL SIGNS:
–
–
–
–
–
–
Syncope
Tiring on exercise
_______________ congested heart failure
________________ basilar (base) murmur (PAM)
Right ventricular enlargement
Radiographs: right ventricular enlargement, dilation of
the pulmonary artery, pulmonary underperfusion
– Echo: right ventricular hypertrophy and enlargement,
dilation of the main pulmonary artery (
__________________________________ )
PULMONIC STENOSIS:
TREATMENT
A special balloon is inserted into the
valve where it is inflated and the
obstruction is broken down: ____________
___________________________
Unfortunately, medical management is not
very beneficial in these cases. __________________________
may be used to relax the heart muscle and
possibly dilate the stenosis.
CLIENT EDUCATION
• Do not breeding
• Mild - moderate pulmonic stenosis: better
__________________
• Moderate - severe pulmonic stenosis: poorer
prognosis
CONGENITAL DEFECTS:
SUBAORTIC STENOSIS
Newfoundland, Boxer, Golden Retriever, and Bull Terrier are most commonly affected
LESION DEVELOPS IN THE FIRST ______________ WEEKS OF LIFE: thickening
Endocardial tissue
CONGENITAL DEFECTS:
SUBAORTIC STENOSIS
• There is a scar-like
narrowing just below the
aortic valve. The heart must
pump _________ to get
blood through the narrowed
area. The blood is pushed
through in a turbulent
fashion creating a heart
murmur.
CONGENITAL DEFECTS: SUBAORTIC
STENOSIS
THE HARD WORK RESULTS IN LEFT VENTRICULAR HYPERTROPHY, LEFT
ATRIAL ENLARGEMENT, AORTIC DILATION: ____________________
CONGENITAL DEFECTS: SUBAORTIC
STENOSIS:
• CLINICAL SIGNS:
– Fatigue
– Exercise intolerance (low cardiac output)
– ______________________
– Systolic murmur (soft – moderate) at the left
heart base
– ECG: evidence of left ventricular enlargement - ↑
QRS height
– Echo: left ventricular hypertrophy, subvalvular
fibrous ring, aortic dilation
CONGENITIAL DEFECTS:
SUBAORTIC STENOSIS
• TREATMENT
– Balloon catheter dilation – has been done with variable
and temporary results
– Medical management: THE GOAL IS TO SLOW THE
HEART RATE AND DECREASE CONTRACTILITY;
________________ (BETA-BLOCKER WILL DO
THIS)
CONGENITAL DEFECTS:
SUBAORTIC STENOSIS
• CLIENT INFO:
– Should not be used for breeding
– Acute, left-sided congestive heart failure is
possible
– ___________________ is not uncommon
DCM
HCM
PDA
Aortic stenosis
Pulmonic
stenosis
•1 – dogs
•Enlarged Heart
bronchile
constriction
•Dilated Flappy
muscle
•Nutritional: no
taurin in cats
•1 – Cats
•Saddle
thrombus
•Rarely in dogs
(hereditary)
•Noncompliant
heart muscle
•Aorta –
pulmonary a –
lungs back L side
•Stenotic aortic
valve causes LV
hypertrophy
•High pressure in
aortic valve can
lead to aortic
dilatation
•Stenotic
pulmonic valve
•Pregnant heart
•L sided heart
failure (HF)
•LV hypertrophy
•RV hypertrophy
•R sided HF
•Increased HR
•Cough
•Increased HR
•Weakness in
hindlimbs, acute
pain, rear cold
feet
•Pulmonary
edema
•Sudden death if
aorta ruptures
•Digoxin:
increased
contractibility
•Beta blocker:
Slow HR
•Diuretic
•Blood thinner
•Treat surgically
or die
•No breeding
•Balloon
valvuloplasty
CONGENITAL DEFECTS:
TETRALOGY OF FALLOT
______________ are the most commonly affected breed,
but bulldogs and cats have increased incidence as well.
Cause: polygenic inheritance
CONGENITAL DEFECTS:
TETRALOGY OF FALLOT
• THERE ARE 4 MAIN ANATOMICAL
ABNORMALITIES IN THIS DISEASE!
– Pulmonic stenosis
– Right ventricular hypertrophy
– Ventricular septal defect
– Overriding aorta
________ to left
shunt:
pulmonary
and systemic
circulations
Overiding aorta:
Blood from RV
into aorta: mixed
blood, not fully
oxygenated blood.
Body
stimulates more RBC
production to
stimulate
oxygen carrying
capacity
CONGENITAL DEFECTS:
TETRALOGY OF FALLOT
• CLINICAL SIGNS and DIAGNOSIS:
–
–
–
–
–
–
Affected puppies are _____________ than littermates
Exercise intolerance
Dyspnea, tachypnea
Syncope
Cyanosis
_________________________: occurs as a response to
the large amount of deoxygenated blood going to the
systemic circulation
– Systolic murmur over the pulmonic area
– ECHO: right ventricular hypertrophy, subaortic
ventricular septal defect, right outflow tract obstruction
CONGENITAL DEFECTS:
TETRALOGY OF FALLOT
• TREATMENT:
– ___________________: to keep PCV below 65%
(replace with crystalloids)
– Surgery:
• Create a _______________________ shunt by doing
systemic artery to pulmonary artery anastamosis
• Complete correction requires cardiopulmonary bypass
which is uncommon in animals
CONGENITAL DEFECTS:
TETRALOGY OF FALLOT
• CLIENT INFO:
– These dogs should not be bred
– Congestive heart failure _____________ develops
– Affected animals need regular phlebotomy
– Limit stress and exercise
– Caution when using sedatives/ tranquilizers
CONGENITAL DEFECTS: PERSISTENT
RIGHT 4TH AORTIC ARCH
Great Danes, German Shepherds, Irish Setters
are most commonly affected
CONGENITAL DEFECTS: PERSISTENT
RIGHT 4TH AORTIC ARCH
Constrict the
esophagus ,
food cannot get
pass and
________________
_______ will be
formed.
CONGENITAL DEFECTS: PERSISTENT
RIGHT 4TH AORTIC ARCH
Main cause of
megaesophagus
in
puppies:
dyspnea
and weight loss.
Clinical signs include regurgitation due to megaesophagus,
______________________, dyspnea, weight loss
PERSISTENT RIGHT
AORTIC ARCH
TH
4
• Dx: ______________________ study
• Tx: Surgery (like PDA); megaesophagus
maintenance; Ab’s for secondary infections
• Client informations
– Do not breed
– Sx is needed
– After sx some megaesophagus hence no boluses of
food