* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Food Animal Cardiology
Survey
Document related concepts
Saturated fat and cardiovascular disease wikipedia , lookup
Cardiovascular disease wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Cardiac contractility modulation wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Heart failure wikipedia , lookup
Coronary artery disease wikipedia , lookup
Jatene procedure wikipedia , lookup
Rheumatic fever wikipedia , lookup
Cardiac surgery wikipedia , lookup
Infective endocarditis wikipedia , lookup
Electrocardiography wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
Dextro-Transposition of the great arteries wikipedia , lookup
Ventricular fibrillation wikipedia , lookup
Transcript
Food Animal Cardiology M. S. Gill, DVM, MS Initial examination Complete physical examination important With special attention given to: – Mucous membrane color – Presence of jugular pulses – Edema Jugular pulse Jugular pulse & edema Examination of the heart Heart occupies ventral position in the thorax Between the 3rd and 6th ribs 3/5’s of heart is on the left side Examination of the heart Auscultation Heart sounds – S1, S2, S3, S4 Areas of auscultation of heart valves Assessment of murmurs Examination of the heart S1 – beginning of ventricular systole (contracting myocardium and closure of AV valves) S2 – closure of the semilunar valves S3 – ventricular filling S4 – atrial contraction Normal sequence S4 – S1 – S2 – S3 Examination of the heart Examination of the heart Grading murmurs – Grade I – Grade II – Grade III – Grade IV – Grade V Grade I is not clinically significant. Grades IV and V are usually significant Evaluation of the heart Heart rate – should equal pulse – Tachycardia – Bradycardia Rhythm – Most common arrhythmia in cattle is atrial fibrillation Congenital cardiac defects Early detection important – Expense – Genetic implications Congenital cardiac defects Ventricular septal defect* – Left to right shunt Tetralogy of Fallot – Right to left shunt, cyanosis Ectopia cordis Patent foramen ovale PDA Vegetative endocarditis Murmur CHF may develop Arcanobacter pyogenes or α-hemolytic strep in cattle, erysipelothrix or strep in swine Lesions on valves are usually embolic in origin Right AV valve usually affected Vegetative endocarditis Clinical signs – – – – Poor doing animal Exercise intolerance CHF Fluctuating fever Clinical pathology – Severe leukocytosis Diagnostics – Blood cultures – Echocardiography Vegetative endocarditis Large cauliflower-like or small verrucous lesions on heart valves, or, Shrunken, scarred heart valves Vegetative endocarditis Vegetative endocarditis Treatment – Cephalosporins/penicillin to calves with omphalophlebitis – Long term, broad spectrum antibiotics to cattle with vegetative endocarditis – Prognosis poor Pericarditis Inflammation of the visceral and parietal pericardium Most likely due to traumatic pericarditis – extension of traumatic reticuloperitonitis Pericarditis Pathophysiology – Penetration of pericardium by metallic foreign body fibrinous exudate effusion with splashing sounds compromised heart function CHF Pericarditis Clinical signs – – – – – – Pain Kyphosis Abduction of elbows Shallow respirations T – 103-106º F Fluid splashing cardiac sounds or friction rubs or muffled heart sounds – CHF may develop late in the course Pericarditis Most cows with pericarditis die in 1-3 weeks Some develop chronic pericarditis Leukocytosis – 16,000-30,000 WBC Pericarditis Pericardiocentesis – Centesis performed at the 4th or 5th intercostal space at the level of the elbow on the left side Pericarditis Pericarditis Fibrin deposition Purulent exudate Thickened pericardium / epicardium Adhesions Possible presence of metallic foreign body Pericarditis Treatment – Not very successful – Long term, broad spectrum antibiotics – 5th or 6th rib resection (pericardiotomy) may be attempted but not very successful Myocardial disease Myocarditis – Inflammation of the myocardial wall (bacterial, viral, parasitic) Cardiomyopathy – Dilated cardiomyopathy is the only form of clinical significance in large animals Myocarditis Bacterial – Staph, Clostridium, 2º to bacteremia or septicemia, pericarditis, endocarditis Viral – FMD Parasitic – Toxoplasmosis, cysticercosis, sarcocystis Myocarditis May be incidental finding at necropsy Treat primary condition – i.e., cow with mastitis Cardiomyopathy Toxicities: – – – – Monensin, lasalocid Gossypol Cassia Phalaris Deficiencies – Vitamin E/Se (WMD or nutritional myodegeneration) – Copper deficiency Cardiomyopathy Other causes – Excess molybdenum – High sulfates – Lymphosarcoma – neoplastic infiltration of myocardium Cardiomyopathy Clinical signs – usually present with CHF Treatment – poor prognosis – treat CHF Cor pulmonale Pulmonary hypertension, brisket disease, high altitude disease, or high mountain disease Cor pulmonale reflects effect of lung dysfunction on heart, therefore, heart disease is secondary Cor pulmonale Pathophysiology: – Pulmonary hypertension dilatation or failure right heart hypertrophy, Underlying cause is hypoxic vasoconstriction caused by – High altitude dwelling (> 6,000 feet) – Pulmonary disease (bronchopneumonia or lungworms) Cor pulmonale Clinical signs – Signs of CHF Treatment – Remove from high altitude – Treat any primary lung disease – Reversible if treated early Differentials for CHF Vegetative endocarditis Pericarditis Myocarditis Cardiac lymphosarcoma Dilated cardiomyopathy Cor pulmonale or brisket disease Electrocardiography Useful for diagnosis of arrhythmias Base-apex lead – Normal ECG: • Small positive P wave (may be notched) • QRS complex is either rS or QS • T is a positive monophasic or negative/positive biphasic wave Normal cattle ECG Atrial fibrillation Most common arrhythmia in cattle Absence of P waves, presence of f waves, ventricular tachycardia with irregular rhythm Atria remain distended & quiver due to numerous independent fronts of depolarization CHF unlikely Atrial fibrillation Organic – underlying heart disease Functional - 2º to other abnormalities – GI disturbances, electrolyte abnormalities, pulmonary disease, brain disease Atrial fibrillation Most cases are functional May be paroxysmal or established May convert to normal sinus rhythm spontaneously Treatment involves correcting underlying condition – quinidine has been used in some cases that don’t correct on own Atrial fibrillation Atrial fibrillation Sinus arrhythmia Premature ventricular contractions Etiology – Primary myocardial disease – Secondary to increased sympathetic tone, hypoxia, anemia, uremia, acidosis, sepsis, hypokalemia or various drugs Rate normal but rhythm irregular QRS complex of a PVC is premature, bizarre, prolonged & of larger amplitude Unifocal or multifocal Treat underlying condition or lidocaine PVC – multifocal or multiform PVC - unifocal Pericarditis