Pericardium. Pericardial Diseases. Function of Pericardium 10/1/2012

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Pericardium. Pericardial Diseases. Function of Pericardium 10/1/2012"

Transcription

1 NO LASIX, PLEASE! PERICARDIAL DISEASE IN THE DOG Pericardium Michael Luethy, DVM Diplomate ACVIM Cardiology September 13 th, 2012 Tough, outer, parietal pericardium Delicate, serous, visceral pericardium (epicardium) Space between layers = pericardial cavity Cavity normally contains 0.2 to 0.3 ml/kg of fluid Fluid concentrated in region of heart base Pericardium Pericardium Function of Pericardium Pericardial Diseases Maintains position of heart within the thorax Lubricates the surface of the heart Protects heart from surrounding infection and neoplasia Ventricular diastolic coupling Restrains ventricular filling during periods of volume overload ~ 7% of cardiac cases in the dog Most diseases are acquired and involve increased fluid in pericardial cavity Congenital diseases are uncommon and include: - Peritoneopericardial diaphragmatic hernia (PPDH) - Pericardial cysts - Congenital absence of the pericardium 1

2 PPDH PPDH Weimaraners predisposed Often asymptomatic Clinical signs depend on what organs are displaced and degree of compromise to blood supply Diarrhea, vomiting, anorexia, respiratory abnormalities PPDH Diagnosis Radiographs Clinical signs Muffled heart sounds Radiography Thoracic Ultrasound Enlarged cardiac silhouette Gas pockets noted over the cardiac silhouette Silhouetting of the cardiac and diaphragmatic borders Non-homogenous opacity of cardiac silhouette due to intrapericardial fat Cranial displacement of abdominal organs PPDH PPDH 2

3 Surgical Correction Pericardial Effusion Young animals Animals with associated clinical signs Potential complications include thromboembolic disease and reperfusion syndrome Neoplastic effusions account for 70 to 80% of cases with clinical signs Idiopathic effusion is the most common nonneoplastic diagnosis for pericardial effusion Bacterial, viral, and fungal infections are infrequent causes of pericardial effusion in the dog May be present as a form of bilateral CHF in dogs with severe CDVD Hemangiosarcoma Hemangiosarcoma Reported more frequently than all other tumor types combined Highest incidence in the Golden Retriever Classically arises from the right atrium or right auricle but may originate from any region of the heart Produces effusion primarily through tumor hemorrhage May be a primary or metastatic lesion Extremely aggressive with rapid metastasis Hemangiosarcoma Heart Base Tumor Denotes a location rather than a tumor type The majority of heart base tumors are aortic body tumors (chemodectomas) English Bulldog, Boxer, and Boston Terrier predisposed Tend to be slow growing, slow to metastasize, and locally invasive Effusion is typically related to inflammation and increased fluid production rather than to hemorrhage 3

4 Heart Base Tumor Aortic Body Tumor Ectopic thyroid tumors are the second most common (adenoma or adenocarcinoma) tumor type Adenomas are slow to metastasize but tend to be locally invasive Adenocarcinomas frequently metastasize Effusion related to inflammation rather than hemorrhage Aortic Body Tumor Other Cardiac Neoplasia Mesothelioma arises from the pericardial sac itself and can be extremely difficult to diagnose Lymphosarcoma most frequently leads to diffuse infiltration of ventricular myocardium and may or may not cause effusion Other forms of neoplasia are reported with extremely low frequency Idiopathic Pericardial Effusion Infectious Pericarditis Most common non-neoplastic diagnosis Medium to large breed dogs (> 20 kg) Golden Retrievers Histopathology demonstrates vasculitis and lymphangitis Underlying cause of the inflammation is unknown Common bacterial and viral causes of human pericarditis not identified Autoimmune etiologies have not been confirmed Uncommon in the dog Most frequently associated with migrating foreign bodies (e.g. foxtail awns) May extend from pulmonary infections 4

5 Clinical Signs Clinical Signs Lethargy Syncope Respiratory distress Gastrointestinal signs Abdominal distension passive congestion & ascites May be chronic or acute Relate to the rate of fluid buildup and degree of cardiac tamponade Cardiac Tamponade Cardiac Tamponade Occurs as increasing pericardial pressure begins to interfere with normal filling and function of the heart Tamponade is not an all or none process and begins with relatively small increases in pericardial fluid volumes As intrapericardial pressure exceeds right heart filling pressure (right heart tamponade), signs of exercise intolerance and venous congestion develop As intrapericardial pressure exceeds left heart filling pressure (left heart or biventricular tamponade), cardiac output becomes severely compromised Cardiac Tamponade Cardiac Tamponade The severity of tamponade and circulatory compromise is related to the intrapericardial pressure and not the amount of fluid present A small amount of fluid that accumulates rapidly may cause severe circulatory collapse Slow fluid accumulation allows for pericardial stretch and may lead to > 1 liter of fluid accumulation with few clinical signs Tamponade may occur more rapidly if a patient is already volume depleted The body depends on elevated venous pressures to push blood into the heart during late diastole 5

6 Physical Examination Jugular Distension Muffled heart sounds Abdominal distension Jugular distension Tachycardia Decreased breath sounds ventrally Decreased systemic blood pressure Pulsus paradoxus ECG Electrical Alternans Sinus tachycardia Ventricular arrhythmias Low voltage complexes Electrical alternans Radiography Generalized cardiomegaly Loss of cardiac angles and waists with globoid cardiac appearance Subjective enlargement of caudal vena cava Pleural effusion Pulmonary edema is rare 6

7 Echocardiography Gold standard for documenting effusion and evaluating myocardium and pericardium Small mass lesions are easy to miss on dorsal surface of RA and right auricle Left parasternal view tends to provide a better view of right atrium, right auricle, and heart base Echocardiography Echocardiography - Tamponade Thrombi may be present in the pericardial cavity in the absence of mass lesions Mesotheliomas do not produce defined mass lesions Tamponade may be present without gross diastolic collapse Better visualization of the right atrium and heart base can be obtained with effusion present RA Hemangiosarcoma With Tamponade RA Hemangiosarcoma With Tamponade 7

8 RA Hemangiosarcoma With Tamponade Fluid Analysis Should be performed on all samples Very good for identifying bacterial and fungal infections save sample for culture Rarely able to identify hemangiosarcoma, aortic body tumors, or ectopic thyroid tumors Extremely poor at identifying mesithelioma (false positives & false negatives) Frequently able to detect lymphosarcoma Treatment Treatment The initial measures are aimed at stabilizing patient condition and overall organ perfusion Remember that venous filling pressure must be high enough to push blood into the tamponaded heart Standard cardiac medications (diuretics and vasodilators) lower venous filling pressure NO LASIX PLEASE! IV fluid therapy is indicated if patient cannot have immediate pericardiocentesis Pericardiocentesis is the primary method used for stabilization of the effusion patient with cardiac tamponade Remember that it is easier to visualize the right atrium, right auricle, and heart base with pericardial effusion present Pericardiocentesis Pericardiocentesis Performed in right 5 th, 6 th, or 7 th intercostal space after local anesthesia of the region General anesthesia is rarely needed Left lateral recumbency preferred so that paraconal interventricular branch of left coronary artery is avoided Know peripheral PCV prior to beginning procedure Have ECG running during the procedure Over the needle catheter (14 ga, 5 ½ in, 14 ga, 2 in, or 18 ga, 1.88 in) advanced through skin and intercostal muscles into the pericardial sac 8

9 Pericardiocentesis Pericardiocentesis Catheter advanced and needle withdrawn when a fluid flash is obtained Stop advancement of catheter and needle if cardiac pulsations are felt or ventricular arrhythmias are noted Remove fluid with slow, steady suction to decrease likelihood of irritating epicardial surface Pericardial effusion of almost all etiologies is typically hemorrhagic in appearance Check PCV and monitor fluid for clot formation if unsure about penetration of the catheter into the right ventricle Treatment - Hemangiosarcoma Treatment Other Neoplasia Average survival with no treatment other than pericardiocentesis is 2 weeks Average survival with Adriamycin as a single agent chemotherapy is anecdotally reported as 6 months Surgery does not improve survival over chemotherapy alone unless acute hemorrhage cannot be stopped without amputation of bleeding area Survival time is lower if gross metastatic disease present Administration of yunnan baiyao anecdotally reported to decrease tumor hemorrhage Aortic body or ectopic thyroid tumors can rarely be surgically excised and do not respond well to chemotherapy Pericardiectomy may provide survival times of > 15 months in patients with these tumors Lymphoma and mesothelioma carry a grave prognosis 9

10 Treatment Idiopathic Pericarditis Constrictive Pericarditis Pericardiocentesis alone will be curative in ~ 50% of cases Average time to recurrence is 4 weeks although much longer times may be noted Options for managing recurrent effusion include: - repeat pericardiocentesis alone - repeat pericardiocentesis followed by immunosuppressive therapy with corticosteroids or colchicine and non-steroidal anti-inflammatories - pericardiectomy Results from hypertrophy and fibrosis of the pericardium May develop with chronic or recurrent effusion, infectious etiologies, or other processes Diagnosis is through clinical presentation, echocardiographic findings, and venous pressure wave changes Treatment requires aggressive pericardiectomy 10

FVMA 2015: Diagnosis and Management of Pericardial Disease PERICARDIAL EFFUSION Pathophysiology of Cardiac Tamponade

FVMA 2015: Diagnosis and Management of Pericardial Disease PERICARDIAL EFFUSION Pathophysiology of Cardiac Tamponade FVMA 2015: Diagnosis and Management of Pericardial Disease Jonathan A. Abbott, DVM, Dipl. ACVIM (Cardiology) VA-MD College of Veterinary Medicine Virginia Tech, Blacksburg, Virginia Pericardial disease

More information

Pericardial Effusions Diagnosis and Treatment

Pericardial Effusions Diagnosis and Treatment The Vet Education International Online Veterinary Conference 2013 Pericardial Effusions Diagnosis and Treatment With Dr Richard Woolley Specialist in Cardio-Respiratory Medicine July2013 Vet Education

More information

What is pericarditis?

What is pericarditis? Pericarditis Guide pericarditis guide The Pericardium The pericardium is a thin, two-layered, fluid-filled sac that covers the outer surface of the heart. It shields the heart from infection or malignancy

More information

Cardiac Masses and Tumors

Cardiac Masses and Tumors Cardiac Masses and Tumors Question: What is the diagnosis? A. Aortic valve myxoma B. Papillary fibroelastoma C. Vegetation from Infective endocarditis D. Thrombus in transit E. None of the above Answer:

More information

Traumatic Cardiac Tamponade. Shane KF Seal 19 November 2003 POS

Traumatic Cardiac Tamponade. Shane KF Seal 19 November 2003 POS Traumatic Cardiac Tamponade Shane KF Seal 19 November 2003 POS Objectives Definition Pathophysiology Diagnosis Treatment Cardiac Tamponade The decompensated phase of cardiac compression resulting from

More information

Pericardial diseases. Pericardial anatomy and function. Pericardial effusions

Pericardial diseases. Pericardial anatomy and function. Pericardial effusions Pericardial diseases Pericardial anatomy and function Anatomy The pericardium is composed of 2 layers surrounding the heart. The external layer (pericardium) is attached cranially on the adventitia of

More information

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours Pleura Visceral pleura covers lungs and extends into fissures Parietal pleura limits mediastinum and covers dome of diaphragm and inner aspect of chest wall. Two layers between them (pleural cavity) contains

More information

CASE 34 (SLIDE C15-00344) PERICARDIAL EFFUSION IN A DOG

CASE 34 (SLIDE C15-00344) PERICARDIAL EFFUSION IN A DOG CASE 34 (SLIDE C15-00344) PERICARDIAL EFFUSION IN A DOG JONATHAN LEBOVITZ, DVM & MPH CANDIDATE, CLASS OF 2016 NICOLE WEINSTEIN, DVM, DACVP VIRGINIA-MARYLAND COLLEGE OF VETERINARY MEDICINE HISTORY AND PHYSICAL

More information

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the

More information

Morgagni Hernia Published on Diagnostic Imaging (http://www.diagnosticimaging.com)

Morgagni Hernia Published on Diagnostic Imaging (http://www.diagnosticimaging.com) Case Studies [1] August 28, 2012 By Harpreet Singh, MD [2] An 82-year-old female patient with a history of chest pain, right side, and dyspnea for three months. Clinical history: An 82-year-old female

More information

Cardiomyopathy (Heart Disease) in Cats

Cardiomyopathy (Heart Disease) in Cats Cardiomyopathy (Heart Disease) in Cats PETVET clinics are well-equipped, full-service, small animal veterinary practices providing comprehensive diagnostic, medical, surgical and dental care. We aim to

More information

Thoracic Cavity. Photo: This normal canine lung collapsed when the thorax was opened and the negative pressure was lost in the thorax.

Thoracic Cavity. Photo: This normal canine lung collapsed when the thorax was opened and the negative pressure was lost in the thorax. Thoracic Cavity There are significant anatomical differences in the mediastinum of domestic animals. For instance, bovines, like humans, have well-developed mediastinal separation between the left and

More information

Preoperative Laboratory and Diagnostic Studies

Preoperative Laboratory and Diagnostic Studies Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no

More information

Heart Disease: Diagnosis & Treatment

Heart Disease: Diagnosis & Treatment How I Treat Cardiology Peer Reviewed Heart Disease: Diagnosis & Treatment Amara Estrada, DVM, DACVIM (Cardiology) University of Florida Background Clinical heart disease is the stage of disease when a

More information

Cardiovascular diseases. pathology

Cardiovascular diseases. pathology Cardiovascular diseases pathology Atherosclerosis Vascular diseases A disease that results in arterial wall thickens as a result of build- up of fatty materials such cholesterol, resulting in acute and

More information

Jacinda Christie, DVM Affiliated Emergency Veterinary Service

Jacinda Christie, DVM Affiliated Emergency Veterinary Service Jacinda Christie, DVM Affiliated Emergency Veterinary Service Overview Respiratory anatomy/physiology Common causes of respiratory distress Initial assessment and stabilization Diagnostics/Therapies Respiratory

More information

Therapy of pleural effusions Modern techniques

Therapy of pleural effusions Modern techniques Therapy of pleural effusions Modern techniques Dr. Melanie Toffel Sugery of the chest Pleural effusion Ethiology In the normal pleural space there is a steady state in which there is a roughly equal rate

More information

CARDIAC TAMPONADE SECONDARY TO INTRAPERICARDIAL TUMOR IN A DOG. CASE REPORT

CARDIAC TAMPONADE SECONDARY TO INTRAPERICARDIAL TUMOR IN A DOG. CASE REPORT Scientific Works. Series C. Veterinary Medicine. Vol. LIX (3) ISSN 2065-1295, ISSN Online 2067-3663, ISSN-L 2065-1295 bstract CRDIC TMONDE SECONDRY TO INTRERICRDIL TUMOR IN DOG. CSE REORT ndrei ISN 1,

More information

The heart then repolarises (or refills) in time for the next stimulus and contraction.

The heart then repolarises (or refills) in time for the next stimulus and contraction. Atrial Fibrillation BRIEFLY, HOW DOES THE HEART PUMP? The heart has four chambers. The upper chambers are called atria. One chamber is called an atrium, and the lower chambers are called ventricles. In

More information

Diseases of peritoneum Lect. Al Qassim University, Faculty of Medicine Phase II Year III, CMD 332 Pathology Department 31-32

Diseases of peritoneum Lect. Al Qassim University, Faculty of Medicine Phase II Year III, CMD 332 Pathology Department 31-32 Diseases of peritoneum Lect Al Qassim University, Faculty of Medicine Phase II Year III, CMD 332 Pathology Department 31-32 Describe the etiology, pathogenesis and types of peritonitis Define ascites and

More information

Bovine heart LSA, Case #94.37374

Bovine heart LSA, Case #94.37374 1. Bovine heart LSA, Case #94.37374 Page - 1 2. Bovine heart LSA Page - 2 3. Bovine heart malignant lymphoma Page - 3 4. Bovine heart LSA, Case #85.0616 Page - 4 5. Canine heart and pericardium mesothelioma,

More information

Objectives. Cardiovascular System: The Heart HEART COVERINGS & WALLS PHYSICAL CHARACTERISTICS OF THE HEART. Chapter 11 p

Objectives. Cardiovascular System: The Heart HEART COVERINGS & WALLS PHYSICAL CHARACTERISTICS OF THE HEART. Chapter 11 p Objectives Cardiovascular System: The Heart Chapter 11 p. 314-325 1. Identify the major anatomical areas of the heart on a model or diagram 2. Trace the pathway of blood through the heart 3. Compare the

More information

The Human Heart. Terms

The Human Heart. Terms The Human Heart Terms Aorta: The largest artery in the body and the primary blood vessel which carries oxygenated blood out of the heart to the rest of the body. Left ventricle: The lower left- hand chamber

More information

Pulmonary Complications after General Anesthesia

Pulmonary Complications after General Anesthesia Pulmonary Complications after General Anesthesia Brent Hadder, M. D. Assistant Professor Division of Surgical Intensive Care Palliative Care Service I have no financial support to disclose. 1 Pulmonary

More information

Hypoplastic Left Heart Syndrome (HLHS)

Hypoplastic Left Heart Syndrome (HLHS) Hypoplastic Left Heart Syndrome (HLHS) Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect in which the left side of the heart (mitral valve, left ventricle, aortic valve, and aorta)

More information

Chronic Postpericardiotomy Syndrome and Cardiac Tamponade Lasting for Two Years after Open Heart Surgery

Chronic Postpericardiotomy Syndrome and Cardiac Tamponade Lasting for Two Years after Open Heart Surgery Case Reports Acta Cardiol Sin 2006;22:170 4 Chronic Postpericardiotomy Syndrome and Cardiac Tamponade Lasting for Two Years after Open Heart Surgery Nai-Chuan Chien and Ta-Chung Shen Postpericardiotomy

More information

Pericardial Effusion. By Nancy Liao

Pericardial Effusion. By Nancy Liao Pericardial Effusion By Nancy Liao 24 y/o female with history of metatropic dysplasia presents with 2 weeks of dry progressive cough, dyspnea, increased work of breathing, somnolence, exhaustion, and diffuse

More information

Diagnosis and Management of Life Threatening Cardiac Emergencies

Diagnosis and Management of Life Threatening Cardiac Emergencies Diagnosis and Management of Life Threatening Cardiac Emergencies Carley Saelinger,VMD, DACVIM (Cardiology) Providing the best quality care and service for the patient, the client, and the referring veterinarian.

More information

Basics of pediatric pulmonary hypertension

Basics of pediatric pulmonary hypertension Basics of pediatric pulmonary hypertension BY EDWARD KIRKPATRICK, DO Edward Kirkpatrick, DO, is a pediatric cardiologist and program director of Pediatric Pulmonary Hypertension at Children s Hospital

More information

Cardiac MR Imaging: from Physics to Protocols Case Examples. Disclosures

Cardiac MR Imaging: from Physics to Protocols Case Examples. Disclosures Cardiac MR Imaging: from Physics to Protocols Case Examples David A. Bluemke, M.D., Ph.D. Professor of Radiology and Medicine Clinical Director, MRI Johns Hopkins University School of Medicine Baltimore,

More information

Case III. Disscussion. the UHP ultrasound protocol. Novel Ultrasound Approach to the Empiric Evaluation of the Undifferentiated Hypotensive Patient

Case III. Disscussion. the UHP ultrasound protocol. Novel Ultrasound Approach to the Empiric Evaluation of the Undifferentiated Hypotensive Patient The UHP Ultrasound Protocol: A Novel Ultrasound Approach to the Empiric Evaluation of the Undifferentiated Hypotensive Patient JOHN S. ROSE, MD,* AARON E. BAIR, MD,* DIKU MANDAVIA, MD, AND DONNA J. KINSER,

More information

Anatomy of the Cardiovascular System 11/7/12. Betty Smoot, PT, DPTSc

Anatomy of the Cardiovascular System 11/7/12. Betty Smoot, PT, DPTSc Anatomy of the Cardiovascular System 11/7/12 Betty Smoot, PT, DPTSc BIOGPHY: Betty Smoot, PT, DPTSc is Assistant Professor in the Department of Physical Therapy and Rehabilitation Science and in the Department

More information

RACE I Rapid Assessment by Cardiac Echo. Intensive Care Training Program Radboud University Medical Centre NIjmegen

RACE I Rapid Assessment by Cardiac Echo. Intensive Care Training Program Radboud University Medical Centre NIjmegen RACE I Rapid Assessment by Cardiac Echo Intensive Care Training Program Radboud University Medical Centre NIjmegen RACE Goal-directed study with specific questions Excludes Doppler ultrasound Perform 50

More information

CONSTRICTIVE PERICARDITIS

CONSTRICTIVE PERICARDITIS 33 Profiles in Constrictive Pericarditis, Restrictive Cardiomyopathy, and Cardiac Tamponade Beverly H. Lorell and William Grossman BHL: Harvard Medical School, Hemodynamic and Molecular Physiology Research

More information

Heart Disorders Glossary

Heart Disorders Glossary Heart Disorders Glossary ABG (Arterial Blood Gas) Test: A test that measures how much oxygen and carbon dioxide are in the blood. Anemia: A condition in which there are low levels of red blood cells in

More information

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS Description of Treatment A major difficulty in treating

More information

INFLAMMATORY PLEURAL EFFUSION

INFLAMMATORY PLEURAL EFFUSION PLEURA- LESIONS LESIONS OF PLEURA Primary Intra pleural bacterial infections Neoplasm (mesothelioma) Secondary A complication of some underlying disease PLEURAL EFFUSION Common manifestation of both primary

More information

Sign up to receive ATOTW weekly - email worldanaesthesia@mac.com

Sign up to receive ATOTW weekly - email worldanaesthesia@mac.com CARDIAC TAMPONADE ANAESTHESIA TUTORIAL OF THE WEEK 283 18 TH MARCH 2013 Peter Odor Andrew Bailey St. George s Hospital, London, UK Correspondence to pete.odor@googlemail.com QUESTIONS Before continuing,

More information

Radiographic Lung Patterns

Radiographic Lung Patterns Radiographic Lung Patterns Systematic approach heart mediastinum vessels lungs pleural space thoracic wall diaphragm/abdomen Lung pathology Most cause INCREASED OPACITY patterns INTERSTITIAL ALVEOLAR BRONCHIAL

More information

Clinically relevant pericardial disease in the cat is

Clinically relevant pericardial disease in the cat is J Vet Intern Med 2007;21:1002 1007 Pericardial Effusion in Cats: A Retrospective Study of Clinical Findings and Outcome in 146 Cats Daniel J. Hall, Frances Shofer, C. Kate Meier, and Meg M. Sleeper Background:

More information

Heart and Vascular System Practice Questions

Heart and Vascular System Practice Questions Heart and Vascular System Practice Questions Student: 1. The pulmonary veins are unusual as veins because they are transporting. A. oxygenated blood B. de-oxygenated blood C. high fat blood D. nutrient-rich

More information

The Circulatory System

The Circulatory System The Circulatory System Terminology Angina Pectoris: Severe suffocation chest pain caused by brief lack of oxygen supply to the head muscle. Aorta: Major systemic artery; arises from the left ventricle

More information

Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology

Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology 1: US of adrenal glands, KLA Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology Ultrasound has quickly become an important

More information

Circulatory System. Obj: Explain the structure of the heart

Circulatory System. Obj: Explain the structure of the heart Circulatory System Obj: Explain the structure of the heart 1 Structure of the Heart Size, shape and location 1. Size of a closed fist 2. In thoracic cavity 3. Apex: the tip of the heart that lies on the

More information

Mast-Cell Tumors Basics

Mast-Cell Tumors Basics Mast-Cell Tumors Basics OVERVIEW Cancerous (known as malignant ) round cell tumor; round cell tumors are made up of cells that appear round or oval on microscopic examination; mast-cell tumors are one

More information

EXAMINATION QUESTIONS (V COURSE)

EXAMINATION QUESTIONS (V COURSE) EXAMINATION QUESTIONS (V COURSE) I. 1. Infective endocarditis. Definition. Etiology, pathogenesis, clinical manifestations. Diagnostic criteria, differential diagnosis, complications and outcomes. Treatment.

More information

Acute heart failure may be de novo or it may be a decompensation of chronic heart failure.

Acute heart failure may be de novo or it may be a decompensation of chronic heart failure. Management of Acute Left Ventricular Failure Acute left ventricular failure presents as pulmonary oedema due to increased pressure in the pulmonary capillaries. It is important to realise though that left

More information

The Anorexic Cat For this reason, any cat that stops eating for any reason is considered an emergency situation.

The Anorexic Cat For this reason, any cat that stops eating for any reason is considered an emergency situation. The Anorexic Cat Introduction Any cat that stops eating (anorexic) or begins to eat much less than their normal amount should be seen by a veterinarian right away. The primary reason why a cat stops eating

More information

Chapter 20: The Cardiovascular System: The Heart

Chapter 20: The Cardiovascular System: The Heart Chapter 20: The Cardiovascular System: The Heart Chapter Objectives ANATOMY OF THE HEART 1. Describe the location and orientation of the heart within the thorax and mediastinal cavity. 2. Describe the

More information

Oncology. Topic-Bile Duct Carcinoma. Topic-Adenocarcinoma, Lung. Topic-Hemangiosarcoma, Spleen and Liver

Oncology. Topic-Bile Duct Carcinoma. Topic-Adenocarcinoma, Lung. Topic-Hemangiosarcoma, Spleen and Liver Topic-Adenocarcinoma, Lung Figure 1. Pulmonary adenocarcinoma. Figure 2. Pulmonary bronchiolar carcinoma. Figure 3. Pulmonary fibrosarcoma. Topic-Adenocarcinoma, Skin (Sweat Gland, Sebaceous) Figure 1.

More information

Exchange solutes and water with cells of the body

Exchange solutes and water with cells of the body Chapter 8 Heart and Blood Vessels Three Types of Blood Vessels Transport Blood Arteries Carry blood away from the heart Transport blood under high pressure Capillaries Exchange solutes and water with cells

More information

Aetiology and Management of Acute Cardiac Tamponade

Aetiology and Management of Acute Cardiac Tamponade Aetiology and Management of Acute Cardiac Tamponade Department of Anaesthesia and Intensive Care, Mater Misericordiae Hospital, Dublin, IREIAND Objective: To review current concepts in the aetiology and

More information

OROPHARYNGEAL NEOPLASIA IN THE DOG AND CAT Richard Walshaw, BVMS, Diplomate ACVS Member VSSO Animal Cancer & Imaging Center, Canton, Michigan

OROPHARYNGEAL NEOPLASIA IN THE DOG AND CAT Richard Walshaw, BVMS, Diplomate ACVS Member VSSO Animal Cancer & Imaging Center, Canton, Michigan OROPHARYNGEAL NEOPLASIA IN THE DOG AND CAT Richard Walshaw, BVMS, Diplomate ACVS Member VSSO Animal Cancer & Imaging Center, Canton, Michigan Incidence: Oropharyngeal neoplasia accounts for approximately

More information

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3 Chest X-rays: Programme 3 In the previous tutorial we looked at the different causes and appearances of increased shadowing in the lungs. I will start this tutorial by briefly looking at the causes of

More information

Aortic Stenosis BRIEFLY, HOW DOES THE HEART WORK?

Aortic Stenosis BRIEFLY, HOW DOES THE HEART WORK? Aortic Stenosis BRIEFLY, HOW DOES THE HEART WORK? The heart has four chambers. The upper chambers are called atria. One chamber is called an atrium, and the lower chambers are called ventricles. In addition

More information

Diagnosis of canine Dilated Cardiomyopathy Dr. Gerhard Wess

Diagnosis of canine Dilated Cardiomyopathy Dr. Gerhard Wess Diagnosis of canine Dilated Cardiomyopathy Dr. Gerhard Wess Diplomate ACVIM (Cardiology) Diplomate ECVIM-CA (Cardiology) Diplomate ECVIM-CA (Internal Medicine) CLINICAL SIGNS OF DCM Symptoms related to

More information

Chest Radiography Interpretation: Reading Chest Films

Chest Radiography Interpretation: Reading Chest Films Chest Radiography Interpretation: Reading Chest Films Lisa Chen, M.D. Assistant Clinical Professor Pulmonary and Critical Care Division Department of Medicine San Francisco General Hospital Michael Gotway,

More information

CARDIO-VASCULAR SYSTEM MODULE. Academic Year 2004-2005 Study Guide

CARDIO-VASCULAR SYSTEM MODULE. Academic Year 2004-2005 Study Guide CARDIO-VASCULAR SYSTEM MODULE Academic Year 2004-2005 Study Guide CVS Objectives At the end of this part of the course the student should be able to recognize: 1. The histology and ultra-structure of the

More information

Edema. Edema can also be caused by certain medical conditions or medications. It is also common in pregnant women.

Edema. Edema can also be caused by certain medical conditions or medications. It is also common in pregnant women. Edema Introduction Edema is swelling caused by extra fluid in the tissue of the body. It usually happens in the feet, ankles and legs, but it can involve your entire body. There are many causes of edema,

More information

CARDIAC PROBLEMS ASSOCIATED WITH THE MPS SYNDROMES

CARDIAC PROBLEMS ASSOCIATED WITH THE MPS SYNDROMES CARDIAC PROBLEMS ASSOCIATED WITH THE MPS SYNDROMES Elizabeth Braunlin, MD, PhD Overview Deposition of storage material (glycosaminoglycan) occurs in the hearts of individuals with all forms of MPS Syndromes.

More information

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013 CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES What are the different basic radiographic densities? Density Characteristics 1. Metal 2. Bone 3. Soft Tissue

More information

Canine Lymphoma Frequently Asked Questions by Pet Owners

Canine Lymphoma Frequently Asked Questions by Pet Owners Canine Lymphoma Frequently Asked Questions by Pet Owners What is lymphoma? The term lymphoma describes a diverse group of cancers in dogs that are derived from white blood cells called lymphocytes. Lymphocytes

More information

Pericardial disease. Usually secondary to systemic or other cardiac diseases. Pericardial fluid accumulations Pericarditis

Pericardial disease. Usually secondary to systemic or other cardiac diseases. Pericardial fluid accumulations Pericarditis Pericardial disease Usually secondary to systemic or other cardiac diseases Pericardial fluid accumulations Pericarditis Pericardial Anatomy Two major components visceral pericardium mesothelial monolayer

More information

5. Management of rheumatic heart disease

5. Management of rheumatic heart disease 5. Management of rheumatic heart disease The fundamental goal in the long-term management of RHD is to prevent ARF recurrences, and therefore, prevent the progression of RHD, and in many cases allow for

More information

Atlas of Chest Imaging

Atlas of Chest Imaging CHAPTER e34 Atlas of Chest Imaging Patricia Kritek John J. Reilly, Jr. This atlas of chest imaging is a collection of interesting chest radiographs and computed tomograms of the chest. The readings of

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

HEART FAILURE ROBERT SOUFER, M.D.

HEART FAILURE ROBERT SOUFER, M.D. CHAPTER 14 HEART FAILURE ROBERT SOUFER, M.D. The heart s primary function is to pump blood to all parts of the body, bringing nutrients and oxygen to the tissues and removing waste products. When the body

More information

Oncology Service WELCOME TO THE UTCVM VETERINARY TECHNICIANS VETERINARY ASSISTANTS

Oncology Service WELCOME TO THE UTCVM VETERINARY TECHNICIANS VETERINARY ASSISTANTS WELCOME TO THE UTCVM Oncology Service During your visit, you will meet a variety of the members of the UTCVM Oncology Service team. The Oncology service is staffed by a group of faculty, residents, interns,

More information

CARDIOVASCULAR SYSTEM THE HEART CIRCULATION

CARDIOVASCULAR SYSTEM THE HEART CIRCULATION CARDIOVASCULAR SYSTEM THE HEART CIRCULATION The heart is a reddish brown, hollow muscular organ about the size of one s fist. It is conical in structure the upper side is broad and is called base while

More information

Practical class 3 THE HEART

Practical class 3 THE HEART Practical class 3 THE HEART OBJECTIVES By the time you have completed this assignment and any necessary further reading or study you should be able to:- 1. Describe the fibrous pericardium and serous pericardium,

More information

Diagnostics: Page 2 of 5

Diagnostics: Page 2 of 5 Proteinuria Proteinuria is a condition in which there are increased amounts of protein in the urine. There are a number of different diseases which can result in proteinuria. In the early stages of the

More information

STRUCTURE OF HUMAN HEART - EXTERNAL FEATURES

STRUCTURE OF HUMAN HEART - EXTERNAL FEATURES STRUCTURE OF HUMAN HEART - EXTERNAL FEATURES CONCEPTS: The heart is a hallow organ. It is situated slightly towards left side in the middle of the thorasic (chest) cavity. It is made up of CARDIAC MUSCLE

More information

UNIVERSITA' DEGLI STUDI DI ROMA TOR VERGATA

UNIVERSITA' DEGLI STUDI DI ROMA TOR VERGATA SYSTEMATIC PATHOLOGY I IIIYear Scientific Field DISCIPLINE TUTOR Systematic Pathology I MED/21 MED/10 Thoracic Surgery Respiratory Diseases Tommaso Claudio Mineo Paola Rogliani MED/10 Respiratory Diseases

More information

Cardiac tamponade as the initial manifestation. pulmonary adenocarcinoma

Cardiac tamponade as the initial manifestation. pulmonary adenocarcinoma doi:10.2478/v10019-007-0025-6 Case report and review of the literature Cardiac tamponade as the initial manifestation of pulmonary adenocarcinoma Mitja Letonja 1 and Andrej Debeljak 2 1 Department of Internal

More information

Certificate of Veterinary Nursing in Emergency & Critical Care. Sample Exam Questions

Certificate of Veterinary Nursing in Emergency & Critical Care. Sample Exam Questions Certificate of Veterinary Nursing in Emergency & Critical Care Sample Exam Questions 1. Question (12 marks) A dyspnoeic dog is presented with a suspected pleural effusion. a) You provide the dog with supplemental

More information

Right-sided infective endocarditis:tunisian experience

Right-sided infective endocarditis:tunisian experience Right-sided infective endocarditis:tunisian experience L. Ammari, A. Ghoubontini, A. Berriche, R. Abdelmalek, S.Aissa, F.Kanoun, B.Kilani, H.Tiouiri Benaissa, T.Ben chaabane Department of Infectious diseases,

More information

Diagnosis & Management of Canine Mast Cell Tumors

Diagnosis & Management of Canine Mast Cell Tumors C o n s u l t a n t o n C a l l O N C O L O G Y Peer Reviewed Laura Garrett, DVM, DACVIM (Oncology) University of Illinois Diagnosis & Management of Canine Mast Cell Tumors PROFILE Definition Mast cell

More information

1400 Telegraph Bloomfield Hills, MI 48302 248-334-6877-Phone number/248-334-6877-fax Number CANCER TREATMENT

1400 Telegraph Bloomfield Hills, MI 48302 248-334-6877-Phone number/248-334-6877-fax Number CANCER TREATMENT 1400 Telegraph Bloomfield Hills, MI 48302 248-334-6877-Phone number/248-334-6877-fax Number CANCER TREATMENT Learning that your pet has a diagnosis of cancer can be overwhelming. We realize that your pet

More information

Ultrasound of the Thorax (Noncardiac)

Ultrasound of the Thorax (Noncardiac) Ultrasound of the Thorax (Noncardiac) Martha Moon Larson, DVM, MS KEYWORDS Ultrasound Thorax Pleural effusion Mediastinum Lung Ultrasound of the noncardiac thorax is an important supplemental imaging modality

More information

1. Organs of the Respiratory System

1. Organs of the Respiratory System S T U D Y G U I D E 14 1. Organs of the Respiratory System a. Label the parts of the upper respiratory tract by placing the numbers of the structures by the correct labels. 11 Conchae 14 Nasopharynx 15

More information

Supraventricular Tachycardia (SVT) and Ablation

Supraventricular Tachycardia (SVT) and Ablation UW MEDICINE PATIENT EDUCATION Supraventricular Tachycardia (SVT) and Ablation Treating your abnormal heart rhythm This handout describes a type of abnormal heart rhythm called supraventricular tachycardia.

More information

TACHYCARDIA INDUCED CARDIOMYOPATHY. Case 1 ECG

TACHYCARDIA INDUCED CARDIOMYOPATHY. Case 1 ECG TACHYCARDIA INDUCED CARDIOMYOPATHY Javier E. Banchs M.D. Associate Professor of Medicine Penn State Hershey Heart & Vascular Institute Case 1 34 year old man with history of tachycardia x 6 months, nausea

More information

HYPERTROPHIC CARDIOMYOPATHY

HYPERTROPHIC CARDIOMYOPATHY HYPERTROPHIC CARDIOMYOPATHY Most often diagnosed during infancy or adolescence, hypertrophic cardiomyopathy (HCM) is the second most common form of heart muscle disease, is usually genetically transmitted,

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Chest Wall, Pleural Space, and Mediastinal Challenges. Maurine Thomson, B.V.Sc, FACVSc. Veterinary Oncology Specialists at VSS

Chest Wall, Pleural Space, and Mediastinal Challenges. Maurine Thomson, B.V.Sc, FACVSc. Veterinary Oncology Specialists at VSS Chest Wall, Pleural Space, and Mediastinal Challenges Maurine Thomson, B.V.Sc, FACVSc. Veterinary Oncology Specialists at VSS Thoracic wall resection and reconstruction Typically this is performed for

More information

Pulmonary Patterns VMA 976

Pulmonary Patterns VMA 976 Pulmonary Patterns VMA 976 PULMONARY PATTERNS Which pulmonary patterns are commonly described in veterinary medicine? PULMONARY PATTERNS Normal Alveolar Interstitial Structured/Nodular Unstructured Bronchial

More information

Section Four: Pulmonary Artery Waveform Interpretation

Section Four: Pulmonary Artery Waveform Interpretation Section Four: Pulmonary Artery Waveform Interpretation All hemodynamic pressures and waveforms are generated by pressure changes in the heart caused by myocardial contraction (systole) and relaxation/filling

More information

Thymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available.

Thymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available. Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against

More information

What is Mesothelioma?

What is Mesothelioma? What is Mesothelioma? Mesothelioma is a rare type of cancer that develops in the mesothelial cells found in one s body. These cells form membranous linings that surround and protect the body s organs and

More information

016 // Right Heart Disease

016 // Right Heart Disease 016 // Right Heart Disease CONTENTS 150 Basics of Pulmonary Hypertension 152 Echo Assessment of Pulmonary Hypertension 155 Disease of the Right Ventricle 155 Right Ventricular Infarction 156 Right Ventricular

More information

Universitätsklinik für Kardiologie. Test. Thomas M. Suter Akute Herzinsuffizienz Diagnostik und Therapie thomas.suter@insel.ch 1

Universitätsklinik für Kardiologie. Test. Thomas M. Suter Akute Herzinsuffizienz Diagnostik und Therapie thomas.suter@insel.ch 1 Test Thomas M. Suter Akute Herzinsuffizienz Diagnostik und Therapie thomas.suter@insel.ch 1 Heart Failure - Definition European Heart Journal (2008) 29, 2388 2442 Akute Herzinsuffizienz Diagnostik und

More information

Anatomy and Physiology: Understanding the Importance of CPR

Anatomy and Physiology: Understanding the Importance of CPR Anatomy and Physiology: Understanding the Importance of CPR Overview This document gives you more information about the body s structure (anatomy) and function (physiology). This information will help

More information

CARDIOLOGY ROTATION GOALS AND OBJECTIVES

CARDIOLOGY ROTATION GOALS AND OBJECTIVES CARDIOLOGY ROTATION GOALS AND OBJECTIVES PGY-1 Core Medicine Rotation The trainee will have the opportunity to develop clinical skills, the ability to analyze patients problems, and make treatment plans

More information

DISEASES OF THE CIRCULATORY SYSTEM

DISEASES OF THE CIRCULATORY SYSTEM DISEASES OF THE CIRCULATORY SYSTEM ACUTE RHEUMATIC FEVER (390 392.9) 390 RHEUMATIC FEVER WITHOUT MENTION OF HEART INVOLVEMENT 391 RHEUMATIC FEVER WITH HEART INVOLVEMENT 391.0 ACUTE RHEUMATIC PERICARDITIS

More information

Atrial Fibrillation Management Across the Spectrum of Illness

Atrial Fibrillation Management Across the Spectrum of Illness Disclosures Atrial Fibrillation Management Across the Spectrum of Illness NONE Barbara Birriel, MSN, ACNP-BC, FCCM The Pennsylvania State University Objectives AF Discuss the pathophysiology, diagnosis,

More information

HYPERTENSIVE HEART DISEASE

HYPERTENSIVE HEART DISEASE HYPERTENSIVE HEART DISEASE Hypertensive heart disease (HHD) stems from the increased demands placed on the heart by hypertension pressure overload + ventricular hypertrophy Most commonly seen in the left

More information

Potential Causes of Sudden Cardiac Arrest in Children

Potential Causes of Sudden Cardiac Arrest in Children Potential Causes of Sudden Cardiac Arrest in Children Project S.A.V.E. When sudden death occurs in children, adolescents and younger adults, heart abnormalities are likely causes. These conditions are

More information

DOM Admission Service Guidance

DOM Admission Service Guidance Acute Care for the Elderly (ACE) Who to Call Who to admit Admission exclusion criteria Ideal Admission Location 1. Age > 75 with indication for general medicine admission (i.e. no medical or surgical specialty

More information

Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology

Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89) The diabetes mellitus codes are combination codes

More information

Heart transplantation

Heart transplantation Heart transplantation A patient s guide 1 Heart transplantation Heart transplantation has the potential to significantly improve the length and quality of life for patients with severe heart failure.

More information