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How many chambers are in the heart?
four
What are the names of the four chambers of the heart?
  1. Right atrium
  2. left atrium
  3. right ventricle
  4. left ventricle
What does the right atrium do?
Receives deoxygenated blood from body via the vena cava
What does the right ventricle do?
Pumps deoxygenated blood to lungs via the pulmonary artery
What does the left atrium do?
Receives oxygenated blood from lungs via the pulmonary vein
What does the left ventricle do?
Pumps oxygenated blood to body via the aorta
Which side of the heart has the highest pressure and why?
the left side; because it has to pump hard enough to circulate through the body
Which side of the heart has the lowest pressure and why?
the right side; because it only has to pump the blood to the heart, too much pressure would rupture the capillaries
How do the lungs oxygenate the blood?
with the Alveoli-Capillary Gas Exchange
What is the path of electricity in the heart?
  • SA node
  • AV node
  • Bundle of HIS
  • Purkinje fibers
What are the waves and what do they represent on an electrocardiogram (ECG)?
  • P wave –Contraction of atria
  • QRS complex –Contraction of ventricles –Repolarization of atria (hidden by vent activity)
  • T wave –Repolarization of ventricles
What happens during heart failure?
returning blood is not pumped fast enough to meet body’s needs
What is congestive heart failure?
when failing heart leads to fluid congestion in
a) lungs (pulmonary edema)
b) body (edema)
What are the two types of cardiomyopathy?
  1. Dialated cardiomyopathy DCM
  2. Hypertrophic cardiomyopathy HCM
What is one of the most commonly acquired heart diseases in dogs?
Canine Dilated Cardiomyopathy
What happens during Canine DCM?
↓ CO (cardiac output), ↑ blood left in heart after systole
What are the signs of Canine DCM?
Giant/large breed dogs; older (4-10 y)
Exercise intolerance
R sided failure
Ascites/abdominal distension
Hepatomegaly
Wt loss
L sided failure
Coughing
Pulmonary edema
Syncope
What will you see on physical examination with Canine DCM?
Weakness, depression
Hypokinetic femoral pulse from low cardiac output
Pulse deficits
Decrease Jugular pulses
HR – fast 150-200+
How do you diagnose Canine DCM?
X-rays may show dilated heart
Ultrasonography will show dilated heart chambers
ECG
widened/large QRS and P waves
rhythm disturbances
Is there a cure for Canine DCM?
no
How you we treat Canine DCM?
Diuretics to ↓ fluid buildup
Digoxin - ↑strength of contraction (↑CO)
Nitroglycerin x 24-48 hrs
OXYGEN
Vasodilators
Pimobendan - + inotrope, increases survival
What do we tell the client about Canine DCM?
Fatal disease (6mo to 2 y) with Sudden death
More prevalent in large breeds
Diet to decrease Na intake
Minimal exercise & let the patient be guide
What heart condition is rare in dogs?
Canine Hypertrophic Cardiomyopathy
What are signs of Canine HCM?
  • Fatigue
  • Cough
  • Tachypnea
  • Syncope
  • ± cardiac murmurs
  • Sudden death
Some animals will be asymptomatic
What will you see on physical exam with Canine HCM?
  • Systolic heart murmur
  • Cardiac gallop rhythm
LH failure:
  • cough
  • dyspnea
  • cyanosis
  • exercise intolerance
How do we diagnose Canine HCM?
  • X-rays may be normal, have La or LV enlargement and/or pulmonary edema
  • Ultrasound shows thickened L vent wall
  • EKG:  Normal or ST segment and T wave abn
How do we treat Canine HCM?
none routinely; we usually don't know about the condition unless there are signs of heart failure
 What do we inform the client of with Canine HCM?
Sudden death and congestive heart failure may occur
What breeds are more suceptable for Canine HCM?
German Shepherd
Rottweiler
Dalmation
Cocker Spaniel
Boston Terrier
Shih Tzu
What is Feline Dilated Cardiomyopathy associated with?
taurine deficiency
What are the signs of Feline DCM?
  • Older, mixed breed (Siamese, Burmese, Abyssinian)
  • Dyspnea, tachypnea
  • Inactivity
  • Anorexia
  • Acute lameness/paralysis (rear legs)
  • Pain/lack of circulation in affected limbs (no pulse due to thromboemboli)
What would you see on a physical exam with Feline DCM?
  • HR variable (fast, normal or slow)
  • Systolic heart murmur
  • Gallop rhythm
  • +/- arrhythmia
  • Hypothermia
  • Increased CRT
  • Tachypnea
  • Quiet lung sound (if pleural effusion)
  • Crackles if pulmonary edema
  • Hypokinetic femoral pulses
  • +/- posterior paresis/paralysis
How do we diagnose feline DCM?
  • clinical signs
  • ECG
  • Ultrasound
  • taurine levels
  • x-ray
How do we treat feline DCM?
  • Oral taurine supplement (250-500 mg/d)
  • Furosemide or lasix (dieretic)
  • Oxygen
  • Digoxin – increases the strength of contractions
  • Aspirin or heparin – prevent thromboemboli
  • Vasodilator; ↓vascular resistance
What do we tell the client regaurding feline DCM?
  • Most dangerous time is first 2 wks of treatment
  • If cat responds to taurine treatment, good prognosis
  • Unresponsive to taurine treatment, poor long-term prognosis
Which cardiomyopathy is more common in neutered males?
Feline Hypertophic Cardiomyopathy
What are the clinical signs of feline HCM?
  • Soft, systolic murmur (grade 2-3/6)
  • Gallop rhythm and other arrhythmias
  • Acute onset of heart failure or thromboembolism
How do you diagnose feline HCM?
  • X-rays—may be normal
  • ECG
  • •↑P wave duration
  • •↑QRS width
  • •Sinus tachycardia
  • Ultrasound
  • •↑L vent wall; dilated L atrium
How do you treat Feline HCM?
  • Diuretics to decrease fluid load on heart
  • Beta blocker to decrease sinus heart rate
  • Calcium channel blocker to reduce blood pressure
What information do we give the client about feline HCM?
  • Affected cats may experience heart failure, arterial embolism, sudden death
  • Cats with HR <200 bpm have better Px than >200 bpm
  • Median survival time ~2 y
What is a common myocardial disease in cats in 10-20% of HCM?
Thromboembolism
Where does a thromboembolism form?
in the left side of the heart
Where does a thromboembolism lodge?
at the femoral trifurcation
What are the clinical signs of a thromboembolism?
  • Acute onset of rear leg pain/paresis
  • Cold, bluish foot pads
  • Lack of femoral pulse
  • History of myocardial disease
How do you diagnose a thromboembolism?
  • Clinical signs
  • Angiography (if available)
How do you treat a thromboembolism?
  • Dissolve clot
  • •TPA (Activase [Genentech])
  • •Heparin
  • Aspirin for prophylaxis
  • •Aspirin is slowly metabolized in cats; must be monitored
What do you inform the client about thromboembolism?
  • Painful, cold, or paralyzed rear legs in cats is an emergency
  • Prognosis is guarded to poor
  • Surgical removal of thrombus is difficult/expensive
What two blood shunts are in a fetal heart?
  1. ductus arteriosus
  2. foramen ovale
What is PDA?
Patent Ductus Arteriosus - failure of ductus arteriosus to close after birth
What are the clinical signs of PDA?
  • Usually female
  • Presence of a loud heart murmur over L thorax
  • Some puppies are asymptomatic
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