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Cardiovascular emer.
clin med.
| Question | Answer |
|---|---|
| What are the technician's role in treatment of cardiovascular emergenices? | Client education, diagnostics/labs, administer drugs and check how effective tx is |
| What are some common presenting signs of cardiovascular emegenices? | Cyanosis, dyspnea, collapse, hind limb paresis, syncope, tachypnea, exercise intolerance and cough. |
| What is heart failure? | The inability of the heart to supply adequate blood flow to meet the demands of the body. |
| What is forward heart failure also called? | Low output |
| What is forward heart failure? | Occurs when the heart can't pump enough oxygeneated blood to the tissues. |
| What are the two types of congestive heart failure? | Left and right side heart failure. |
| What is left sided heart failure? | Increased pulmonary venous pressure causes fluid to leak from vessels into lungs/thoracic cavity. |
| What is right sided heart failure? | increased systemic venous pressure causes fluid leaks out into abdominal and thoracic cavity. |
| What are some physical findings in patients with heart disease? | Heart murmurs, weak arterial pulses, irregular pulses, pulse deficits and changes in heart sounds. |
| What are some clinical signs of right sided heart failure? | Venous distention, hepatomegaly, ascites, weakness, weight loss and abdominal distention |
| What are clinical signs of left sided heart failure? | Dyspnea, tachypnea, exercise intolerance, cyanosis, weakness, pulmonary edema and cough. |
| What do we notice first left or right sided heart failure? | Left |
| How do you diagnosis heart failure? | Thoracic radiographs, echocardiography and ECG. |
| What will you see on thoracic radiographs? | Increase in size of pulmonary veins, increased opacity of lungs(left sided), left atrial enlargement and enlarged vena cava(right sided). |
| What is seen on an echocardiogram with heart failure? | Left atrial enlargement. |
| What are common emergencies caused by congestive heart failure? | Pulmonary edema, pleural effusion and severe ascites |
| Should we avoid physical restraint with congestive heart failure? | yes, we don't want to stress the patient. |
| What are the three therapys for congestive heart failure? | Diuretics, Oxygen and Drug therapy. |
| What is the goal of diuretic therapy? | Work on the kidneys to increase water and salt elimination. |
| What diuretic is used for pulmonary edema caused by CHF? | Furosemide |
| What is the goal of oxygen therapy? | Improve oxygenation and reduces work of breathing. |
| What are three ways to give oxygen? | Face mask, nasal insufflation and oxygen cage. |
| What drugs are given for CHF? | Vasodilators(Enacard), Postive inotropes and sympathomimetics(Dopamine and dobutamine) |
| What does dobutamine do? | Increase contractility without causing major increases in heart rate. |
| What does dopamine do? | Useful when poor contractility is associated with hypotension. |
| If therapy is effective what signs will you see? | Improved attitude, decreased respiratory rate, improved mm color and animal lies down and sleeps. |
| What heart disease is caval syndrome a complication of? | Heartworm disease. |
| What does caval syndrome cause? | Large numbers of heartworms enter the right atrium and entwine in the tricuspid valve causing tricuspid regurgitation. Also hemolysis of RBC's as they are forced through the heartworms. |
| What are some signs of caval syndrome? | Anorexia, weakness, depression, hemoglobinuria, dyspnea and cough. |
| How can you tell the difference between hemoglobinuria and hematuria? | When centrifuged hemoglobin stays red. |
| How do you diagnose caval syndrome? | Thoracic radiographs-right heart enlargement and pulmonary artery enlargement. Echocardiography-worms appear as parallel lines. |
| should we give this patient immiticide? | No, can cause reaction and worms may go into lungs. |
| What is the prognosis of caval syndrome even with treatment? | Very poor, high mortality. |
| What is pericardial effusion? | Accumulation of fluid within the pericardial sac. |
| What are some common causes of pericardial effusion? | Neoplasia and pericarditis are most common, trauma, atrial tears and right atrial hemangiosarcoma. |
| With acute accumulation of fluid does the heart have time to compensate. | No and it can cause shock. |
| What can an echocardiogram detect? | Fluid within the pericardial sac. |
| What are some signs of pericardial effusion? | Ascites, jugular venous distension, cachexia, tachycardia, weak pulses and muffled heart sounds. |
| How do we treat pericardial effusion? | Pericardiocentesis.(cut at the 4-5th intercostal space) |
| When cutting into the heart if the needle touches the myocardium what can we see on the ECG? | PVC's |
| What is Feline Aortic Thromboembolism(FATE) a complication of? | Feline Heart disease. |
| What heart disease do cats usually get? | Hypertrophic cardiomyopathy. |
| What causes FATE? | Thrombi develop in heart, dislodge, travel to the systemic arteries and lodge in the distal aorta. |
| Can survivors often lose skin, toes or limbs? | Yes due to the clots in the limbs and paralysis. |
| What are signs of FATE? | Paralysis, pain, rear legs are cold, femoral pulse weak to absent, heart murmur, dyspnea and tachypnea |
| How do we diagnosis FATE? | Thoracic radiographs, angiography, echocardiogrpahy and ECG abnormalities. |
| How do we treat FATE? | Supportive-pain tx, heparin, fentanyl patch. Surgical-removal of aortic arteriotomy Thrombolytic-removes embolus from aorta without anesthesia and sx |
| What is the prognosis for FATE even with treatment? | Poor, high mortality. |
Created by:
kaybaby323
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