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Heartworms and Heart Murmurs. An introduction to problems that can occur in the heart. Partnership for Environmental Education and Rural Health Texas A&M University http://peer.tamu.edu. The Heart. Basic Anatomy. Arteries – Carry blood away from the heart Veins – Carry blood to the heart

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heartworms and heart murmurs

Heartworms and Heart Murmurs

An introduction to problems that can occur in the heart

Partnership for Environmental Education and Rural Health

Texas A&M University


basic anatomy
Basic Anatomy
  • Arteries – Carry blood away from the heart
  • Veins – Carry blood to the heart
  • Capillaries – Site of gas exchange
the heart as a pump
The Heart as a Pump
  • The heart works as a pump, forcing blood forward into the arteries.
  • Blood returns to the heart in veins. Veins have valves.
  • Valves work to keep the blood from flowing backwards, even when the heart isn’t contracting.
what are they
What are they?
  • Parasitic worms that live in the heart and blood vessels of animals.
  • Heartworms (Dirofilaria immitis) affect dogs, coyotes, sea lions, ferrets and cats.
  • They are transmitted by mosquitoes
life cycle of a heartworm
Life Cycle of a Heartworm

Microfilaria develop into larva (L3) in the mosquito

Microfilaria are transmitted to a new mosquito when it bites the infected dog

Larvae are transmitted to the dog when the mosquito takes a blood meal

Larvae continue to mature in the dog until they become adults

Adult heartworms live in the heart and mate to produce microfilaria

Microfilaria are released into the bloodstream


Seen at 400x magnification

clinical signs
Clinical Signs
  • Coughing
  • Exercise intolerance
  • Syncope (Fainting)
  • Ascites (Fluid in the belly)
radiographs of heartworm disease
Radiographs of Heartworm Disease

Enlarged Right Atrium

Widened Caudal Vena Cava (Caval Syndrome)

Enlarged Pulmonary Arteries

Lung Disease (Heartworm Pneumonitis)

  • Prevention products make sure dogs don’t get heartworms in the first place
  • Include: Heartgard, Interceptor, Sentinel, Revolution, Filaribits
  • As long as the animal is medicated every month, it prevents any larvae from maturing and reaching the heart, thus stopping heartworm disease.
  • Treatment products help cure the animal once it already has heartworms
    • Elimination of heartworms is a two step process
    • Must get rid of adult worms and larvae separately
  • Consists of two shots in the muscle of Immiticide and 4 weeks of strict cage rest
heart murmurs
Heart Murmurs
  • What is a heart murmur?
    • A heart murmur is an extra or unusual sound heard during a heartbeat.
    • There are many kinds of murmurs, some that are insignificant and some that indicate a heart problem is present.
patent ductus arteriosus
Special type of heart problem

Breakdown the words:

Patent: to make open

Ductus: tube or canal

Arterio: relating to an artery

Put the words together to see that it means there is an artery that is open (that should be closed!)

Patent Ductus Arteriosus
pda in canines
PDA in canines
  • Most common canine congenital (present at birth) heart problem
  • Affects 5 out of 1000 dogs, in any size or breed
  • 65% of dogs with this problem will die by 1 year of age if it is not fixed
  • Most have the problem diagnosed between 1 month and 3 ½ years of age
pda in humans
PDA in humans
  • The estimated incidence is from 6 out of every 100,000 live births up to 2 out of every 10,000 live births.
  • This incidence is increased in children who are born prematurely.
  • The death rate is very low except in extremely premature infants.
  • It occurs twice as often in girls as in boys.
  • Can a patient live normally?
    • Sometimes there are no symptoms
    • In large PDAs, symptoms can include:
      • Exercise intolerance
      • Sweating
      • Dyspnea (difficulty breathing)
      • Poor weight gain

Audio of a PDA murmur

Audio of a normal heart

management options
Management Options
  • Observation and monitoring
  • Medical Management
    • Medications may be prescribed to reduce blood pressure, maintain normal heart rhythm, and prevent fluid overload.
  • Surgical
    • Surgical repair
      • Ligating (suturing closed) the patent artery
    • Catheter based occlusion
      • Placing a “coil” inside the artery to stimulate closure

Surgical Ligation





catheter based occlusion
Catheter Based Occlusion
  • With a surgery called Transarterial Ductal Occlusion With Coils
    • Very safe procedure
    • Very successful procedure (95% need nothing else)
transarterial ductal occlusion
Transarterial Ductal Occlusion

Aorta (with catheter inside)


Coil within PDA

*Notice how no dye is visible in the pulmonary artery anymore!

Pulmonary Artery