Term
| True or FAlse: CHF is a clinical syndrome. |
|
Definition
| -TRUE, not a definitive diagnosis |
|
|
Term
| What are the 4 general causes of HF? |
|
Definition
-V overload
-P overload
-dec ventricular compliance
0myocardial failure |
|
|
Term
| In dogs, what clinical signs do we see w/ left sided HF? |
|
Definition
| -pulmonary edema: dyspnea, coughing, pulmonary crackles & wheezes |
|
|
Term
| In dogs, what clinical signs do we see w/ right sided HF? |
|
Definition
-abdominal distention +/- fluid wave
-hepatomegaly
-ascites
0pleural effusion: muffled heart/lung sounds, dyspnea
-rares subQ edema
-arrhythmias |
|
|
Term
| What is forward failure? Acute or chronic issue? |
|
Definition
-system is not pumping well so not getting enough fluid in vessels
-more acute |
|
|
Term
| What are the typical clinical signs of forward failure? |
|
Definition
-hypotension
-hypothermia
-bradycardia
-dec perfusion |
|
|
Term
| What is the number one tool for cardio diagnostics? |
|
Definition
|
|
Term
| Which animals do we use T4 on in cardio? |
|
Definition
|
|
Term
| What rad signs do we see w/ LCHF? |
|
Definition
-enlarged LA
-pulmonary venous congestion
-pulmonary infiltrates |
|
|
Term
| When do classic rad signs of LCHF not always apply? |
|
Definition
-animals on diuretics: falsely normal pulmonary veins
-LA in cats difficult to see (look at left auricle)
-acute CHF: may not allow time for significant chamber enlargement
-CATS HAVE PLEURAL EFFUSION W/ LCHF |
|
|
Term
| True or FAlse: Chylothorax can occur secondary to heart dz in cats. |
|
Definition
-TRUE
-heart dz, idiopathic, neoplasia (lymphoma) |
|
|
Term
| When should you run a BNP on a cat? On a dog? |
|
Definition
-on symptomatic cats ONLY
-less awesome in dogs |
|
|
Term
|
Definition
| -the degree of stretch of the heart |
|
|
Term
| What does troponin tell us? |
|
Definition
|
|
Term
| What are the treatment goals for CHF? |
|
Definition
| -maintian adequate tissue perfusion at a lower end diastolic volume AND reduce fluid accumulation |
|
|
Term
|
Definition
-dec preload: diuretics
-dec afterload: dec BP
-inc contractility: Pemobendin
-treat arrhythmias: Dobutamine
-restrict dietary Na
-restrict activity
-anticoagulant (cat)
-treat underlying causes |
|
|
Term
| Why do we give CHF cats anticoagulants? |
|
Definition
| -big LA => blood stass => throw clots in cats w/ CHF => give anticoagulants |
|
|
Term
| How do we manage CHF in the hospital? What does everything fix? |
|
Definition
-Furosemide: preload
-Oxygen
-Nitroglycerine ointment: preload
-Pimobendan (dogs ONLY): positive inotrope and dec afterload
-no IV fluid
-sedation (butorphanol) |
|
|
Term
| What does nitroglycerine ointment do for CHF? |
|
Definition
| -causes venodilation to shunt blood away from the lungs |
|
|
Term
| What are the clinical signs of cardiogenic shock? |
|
Definition
-hypotension
-hypothermia
-bradycardia: esp cats
-dobutamine CRI |
|
|
Term
| Emergency rushes into the clinic in shock. You give fluids etc and they just get worse. What then? |
|
Definition
|
|
Term
| How do we treat acute (fulminant) CHF? |
|
Definition
|
|
Term
| What do we do w/ cavitary effusions? |
|
Definition
-abdominocentesis
-throacocentesis |
|
|
Term
| What is our at home therapy for dogs w/ CHF? What do they fix? |
|
Definition
-diuretic: preload
-ace inh: afterload (cardioprotective)
-Pimobendan: inodilator (dogs)
-Spironolactone: preload (blocks aldosterone)
-dec dieatary Na
-fish oils
-add antiarrhythmic beta blockers after CHF resolved
- |
|
|
Term
| What is the at home therapy for cats w/ CHF? |
|
Definition
-Diuretic
-Ace inh
-anticoagulant: clopidogrel
-sometimes Spironolactone
-Pimobenden
-No beta blockers or diltiazen until after CHF resolves |
|
|
Term
| What do we monitor when treating CHF? |
|
Definition
-dehydration
-potassium
-renal function
-arrhythmias
-signs of recurring CHF |
|
|
Term
| How do we assess renal function quickly in CHF patients? |
|
Definition
-BUN
-creatinine
-electrolytes |
|
|
Term
| What are we looking for when we check BP on a CHF patient? |
|
Definition
| -hypotension due to drugs |
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