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Food Animal Cardiology

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.

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Food Animal Cardiology

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  1. Food Animal Cardiology M. S. Gill, DVM, MS

  2. Initial examination • Complete physical examination important • With special attention given to: • Mucous membrane color • Presence of jugular pulses • Edema

  3. Jugular pulse

  4. Jugular pulse & edema

  5. 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

  6. Examination of the heart • Auscultation • Heart sounds • S1, S2, S3, S4 • Areas of auscultation of heart valves • Assessment of murmurs

  7. 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

  8. Examination of the heart

  9. 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

  10. Evaluation of the heart • Heart rate – should equal pulse • Tachycardia • Bradycardia • Rhythm • Most common arrhythmia in cattle is atrial fibrillation

  11. Congenital cardiac defects • Early detection important • Expense • Genetic implications

  12. Congenital cardiac defects • Ventricular septal defect* • Left to right shunt • Tetralogy of Fallot • Right to left shunt, cyanosis • Ectopia cordis • Patent foramen ovale • PDA

  13. 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

  14. Vegetative endocarditis • Clinical signs • Poor doing animal • Exercise intolerance • CHF • Fluctuating fever • Clinical pathology • Severe leukocytosis • Diagnostics • Blood cultures • Echocardiography

  15. Vegetative endocarditis • Large cauliflower-like or small verrucous lesions on heart valves, or, • Shrunken, scarred heart valves

  16. Vegetative endocarditis

  17. Vegetative endocarditis • Treatment • Cephalosporins/penicillin to calves with omphalophlebitis • Long term, broad spectrum antibiotics to cattle with vegetative endocarditis • Prognosis poor

  18. Pericarditis • Inflammation of the visceral and parietal pericardium • Most likely due to traumatic pericarditis – extension of traumatic reticuloperitonitis

  19. Pericarditis • Pathophysiology • Penetration of pericardium by metallic foreign body fibrinous exudate effusion with splashing sounds compromised heart function CHF

  20. 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

  21. Pericarditis • Most cows with pericarditis die in 1-3 weeks • Some develop chronic pericarditis • Leukocytosis – 16,000-30,000 WBC

  22. Pericarditis • Pericardiocentesis • Centesis performed at the 4th or 5th intercostal space at the level of the elbow on the left side

  23. Pericarditis

  24. Pericarditis • Fibrin deposition • Purulent exudate • Thickened pericardium / epicardium • Adhesions • Possible presence of metallic foreign body

  25. Pericarditis • Treatment • Not very successful • Long term, broad spectrum antibiotics • 5th or 6th rib resection (pericardiotomy) may be attempted but not very successful

  26. Myocardial disease • Myocarditis • Inflammation of the myocardial wall (bacterial, viral, parasitic) • Cardiomyopathy • Dilated cardiomyopathy is the only form of clinical significance in large animals

  27. Myocarditis • Bacterial • Staph, Clostridium, 2º to bacteremia or septicemia, pericarditis, endocarditis • Viral • FMD • Parasitic • Toxoplasmosis, cysticercosis, sarcocystis

  28. Myocarditis • May be incidental finding at necropsy • Treat primary condition – i.e., cow with mastitis

  29. Cardiomyopathy • Toxicities: • Monensin, lasalocid • Gossypol • Cassia • Phalaris • Deficiencies • Vitamin E/Se (WMD or nutritional myodegeneration) • Copper deficiency

  30. Cardiomyopathy • Other causes • Excess molybdenum • High sulfates • Lymphosarcoma – neoplastic infiltration of myocardium

  31. Cardiomyopathy • Clinical signs – usually present with CHF • Treatment – poor prognosis – treat CHF

  32. 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

  33. Cor pulmonale • Pathophysiology: • Pulmonary hypertension right heart hypertrophy, dilatation or failure • Underlying cause is hypoxic vasoconstriction caused by • High altitude dwelling (> 6,000 feet) • Pulmonary disease (bronchopneumonia or lungworms)

  34. Cor pulmonale • Clinical signs • Signs of CHF • Treatment • Remove from high altitude • Treat any primary lung disease • Reversible if treated early

  35. Differentials for CHF • Vegetative endocarditis • Pericarditis • Myocarditis • Cardiac lymphosarcoma • Dilated cardiomyopathy • Cor pulmonale or brisket disease

  36. 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

  37. Normal cattle ECG

  38. 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

  39. Atrial fibrillation • Organic – underlying heart disease • Functional - 2º to other abnormalities • GI disturbances, electrolyte abnormalities, pulmonary disease, brain disease

  40. 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

  41. Atrial fibrillation

  42. Atrial fibrillation

  43. Sinus arrhythmia

  44. 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

  45. PVC – multifocal or multiform

  46. PVC - unifocal

  47. Pericarditis

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