Diseases of the Cardiovascular System I

Diseases of the Cardiovascular System I: Congenital Diseases

• This presentation covers congenital cardiovascular diseases.
• Learning objectives include reviewing cardiac anatomy, fetal circulation, and cardiac imaging modalities.
• Understanding cardiac murmur grading and recognizing common murmur types.
• Reviewing both common and uncommon congenital defects and their influence on blood flow patterns.
• Understanding pathophysiology, clinical presentation, diagnosis, treatment, and prognosis for common congenital cardiac conditions.

Learning Objectives

• Review cardiac anatomy, fetal circulation, and cardiac imaging modalities.
• Understand cardiac murmur grading and recognize common murmur types.
• Review both common and uncommon congenital defects and how they influence blood flow patterns.
• Understand and describe the pathophysiology, clinical presentation, diagnosis, treatment/management, and prognosis for common congenital cardiac conditions (e.g., patent ductus arteriosus, pulmonic stenosis, subvalvular aortic stenosis, atrial and ventricular septal defects).

Anatomy Review

• Images and descriptions of heart anatomy are presented. Labels for various parts of the heart are shown.

Review: Conduction System

• The electrical conduction system of the heart is explained, beginning with the SA node (pacemaker).
• Pathway of electrical signals through the heart is detailed.
• Images illustrate the conduction pathways.

Review: The Heart as a Pump

• The heart is described as two pumps working in series.
• The left side pumps oxygenated blood, and the right side pumps deoxygenated blood.
• Pressures within the heart are noted (e.g., 120/80, 25/10).
• A graph shows the pressure changes throughout the cardiac cycle.

Refresher: Fetal Circulation

• Structures present in utero that are normal include the ductus arteriosus, foramen ovale, ductus venosus, and umbilical arteries and veins.
• After birth, these structures should close.
• Congenital heart defects can result from persistent fetal structures or dysplasia.

Refresher: Basic Echocardiography

• Echocardiography views are described (e.g., right parasternal long axis, right parasternal short axis, subcostal, left apical 4 and 5 chamber).

Right Parasternal Long Axis View

• The long-axis view and 4-chamber views are described and illustrated.

Right Parasternal Short Axis View

• The transducer is rotated to a perpendicular view, and the various structures are viewed in short axis.

Left Apical "5" Chamber View

• Detailed look at the left side of the heart, and its various chambers.

Cardiac Murmurs

• Murmurs are caused by turbulent blood flow.
• Murmur characteristics include pitch, intensity, duration, and quality.
• Harsh murmurs (ejection murmurs) are linked to valve stenosis (narrowing).
• Soft murmurs (blowing murmurs) suggest valve regurgitation (leakage).
• Continuous murmurs are continuous sounds caused by things like patent ductus arteriosus.

Cardiac Murmurs: "Innocent" Murmurs

• Murmur intensity doesn't always correlate with disease severity.
• Murmurs in young animals (puppies and kittens), can be benign.
• Low-grade murmurs are common and may relate to physiological changes.
• Characteristics of "innocent" murmurs are noted (usually dynamic, lower grade, disappear eventually).
• Echocardiography can confirm diagnosis.

Comparison of auscultatory and echocardiographic findings in healthy adult cats

• Data on murmurs and heart issues in healthy adults is tabulated.

In Summary

• Brief summary of the significance of heart murmurs in cats based on age.
• Heart murmur prevalence values tabulated.

Cardiology in Two Pictures

• A cartoon depicts a firefighting analogy to convey the importance of early diagnosis.

Canine Heart Sounds

• Information and a link to audio examples of normal and abnormal heart sounds in dogs are included.