Heart vs Lung Student PDF

HEART VS. LUNG Hillary Hammond DVM, MS, DACVIM (Cardiology) Akaterina Davros DVM, DACVECC Amber Harris DVM, DACVIM (SAIM)  LEARNING OBJEC TIVES Identify history, physical exam findings, and diagnostics to aid in differentiating cardiovascular vs. respiratory as the primary e...

HEART VS. LUNG Hillary Hammond DVM, MS, DACVIM (Cardiology) Akaterina Davros DVM, DACVECC Amber Harris DVM, DACVIM (SAIM)  LEARNING OBJEC TIVES Identify history, physical exam findings, and diagnostics to aid in differentiating cardiovascular vs. respiratory as the primary etiology for common emergency case presentations. Understand common broad categories for causes of increased respiratory rate in a cat or dog. Use diagnostic stewardship and spectrum of care to determine the most appropriate diagnostic plan for an individual pet.  CASE 1 MILO – 12 YO MN DSH  WHAT’S NEXT? 12,100+ Stethoscope Clipart Stock Illustrations, 780+ Medical History Form Stock Illustrations, Royalty-Free Vector Graphics Clip Art - iStock Royalty-Free Vector Graphics Clip Art - iStock | Medical form, Patient chart, Paperwork POC Bloodwork Physical Exam Clinical History POCUS  HISTORY Owner noticed abnormal breathing pattern yesterday. Breathing pattern is worsening as time goes on. Otherwise, Milo is a healthy, normal cat. Tabby cat - Wikipedia  Cardiovascular: HR: 240 bpm, regular No murmur Gallop sound Pulses are fair and synchronous PHYSIC AL EXAM Respiratory: Rapid, shallow breathing Decreased lung sounds ventrally, increased bronchovesicular sounds Tabby cat - Wikipedia dorsally SNAP NT PRO BNP Tabby cat - Wikipedia  Tabby cat - Wikipedia POCUS - THORAX  PHYSIC AL EXAM With CM W/O CM Heart Murmur ~50-80% ~35% Gallop Sound ~20% ~4% Arrhythmias ~10% >>> carcinoma, sarcoma, mesothelioma, mast cell tumor Other causes: pyothorax, idiopathic chylothorax, trauma, FIP, nontraumatic diaphragmatic hernia, uremia, Dominguez Ruiz et al “Characterization of and factors associated with causes of pleural effusion in cats” JAVMA vasculopathy  NT-PRO BNP BIOMARKER Preprohormone Brain Natriuretic Peptide (BNP) Synthesized as preprohormone Stored in myocytes as prohormone Released in response to myocardial stretch/ stress Prohormone Increase severity of disease → increase in concentration proBNP Active form is the C-terminus Functions as diuretic and vasodilator Inactive form is NT-terminus Measured in circulation Excreted in urine C-terminus NT-terminus  ABNORMAL = > 100 PMOL/L False Elevation: Azotemia, Pulmonary Hypertension, Hyperthyroidism, Systemic Hypertension  IT’S THE HEART! No murmur ≠ no heart disease in cats. Gallop sounds are more specific for heart disease. The most common cause of pleural effusion in cats is congestive heart failure. NTproBNP is a cardiac biomarker for myocardial stretch and stress. If abnormal proBNP, recommend further diagnostics like… Thoracic radiographs Echocardiogram Case 2: Cinder vs. Cinder 3yo FS Chihuahua Presents to ER for coughing and a syncopal (fainting) episode  What Next? Checklist with solid fill Stethoscope with solid fill Ultrasound Probe Clipart Images | Free... History Physical POCUS Lungs with solid fill Test tubes with solid fill Exam Thoracic X-Rays Bloodwork  Chihuahua Dog Breed Information... History Adopted 3 weeks ago from Florida 2 weeks ago, started coughing and developed exercise intolerance This morning, she was out in the yard, chased after a squirrel and then had a syncopal episode that lasted about 15 seconds She has since been tachypneic and dazed Cinder is not on any medications and her history prior to adoption is unknown  Physical Exam Temperature: 100.7F Pulse Rate: 210 bpm Respiratory Rate: 90 breaths/minute General: Quiet, alert, and responsive on presentation CV: Grade III/VI right systolic heart murmur. No arrythmias. Mucous membranes pink/moist, capillary refill time