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Cardiovascular emer.

clin med.

QuestionAnswer
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