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Exam II
CHF
28
Veterinary Medicine
Professional
02/06/2017

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Cards

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
-rads!!!
-w/ hx & PE
Term
Which animals do we use T4 on in cardio?
Definition
-cat > 7y
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
What does BNP tell us?
Definition
-the degree of stretch of the heart
Term
What does troponin tell us?
Definition
-myocardial damage
Term
What are the treatment goals for CHF?
Definition
-maintian adequate tissue perfusion at a lower end diastolic volume AND reduce fluid accumulation
Term
How do we manage CHF?
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
-think cardiogenic shock
Term
How do we treat acute (fulminant) CHF?
Definition
-nitroprusside: fixes BP
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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