Apollo College of Veterinary Medicine

Circulatory System

Assistant Professor
Dr Om Prakash Meena
Department of Veterinary Medicine
 Cardiovascular System
• The primary function of the cardiovascular system is to ensure an adequate circulation of
blood so that nutrients are delivered, waste products are removed and a homeostatic is
maintained at the organ and cellular level.
• An inadequate circulation interferes with nutrient delivery and waste product removal,
ultimately leading to circulatory failure, the primary concept in diseases of the
cardiovascular system.
• The two functional units of the cardiovascular system are the heart and the blood vessels;
these two units are best characterized as a pump (the heart) and a circuit (the blood vessels
and blood).
 HEART
• In all animals, the heart is situated in the thorax cavity.
• The base of heart in cattle is situated at the level of 3rd to 6th rib while
apex is just opposite to the joint formed by 6th costal cartilage with
sternum which is about 2 cm away from diaphragm.
• On left side of thorax, the heart is in contact with thoracic wall from 3rd
rib to 4th inter-costal space.
• In horses, the heart is asymmetrical as left side has more than half
portion.
• The base of heart is situated at the level of junction of middle and dorsal
thirds of the dorso-ventral diameter of thorax.
 Examination of Heart
• The examination of heart can be performed through palpation, percussion, auscultation, electrocardiography and
phonocardiography.

• The cardiac sounds are of three types:

1. Transient Cardiac sounds:

• Transient sounds are the normal heart sounds which include sound I, II, III and IV, diastolic ‘gallop’ and systolic ‘extra’ sound
which are of shorter duration.
• a. First heart sound is loud, prolonged and dull. This occurs after a pause.
• b. Second sound is short and sharper; this sound occurs immediately after first sound. The first and second sounds are manifested
by “lub-dupp” sound.
• c. The third heart sound is weak and recognized in certain cardiac diseases which occurs immediately after the second sound.
• d. The fourth sound of heart is detected by phonocardiography which is very complex and have two components.
 2. Murmur cardiac sounds:
• These sounds originate from inside the heart due to endocardial lesions including
valvular vegetations or adhesions.

• Cardiac murmurs are observed when blood flows through a narrow opening.

• Mitral murmurs in horse and dogs are loudest on left side at 5th intercostal space.

• Ruminants have mitral murmurs at 4th intercostal space.

• Pulmonary murmurs are felt on left side at 3rd intercostal space in ruminants, dogs
and horses.

• The tricuspid valve murmurs are louder and clear on right side at 4th intercostal
space.
 3. Pericardial frictional sounds:
• Pericardial frictional sounds are observed due to inflammatory
conditions or adhesions of pericardium causing roughening of the
pericardial surface.
• These sounds are not related to the cardiac cycle.
• Tinkling sounds in cardiac area are suggestive of pneumopericardium
which are readily observed in traumatic pericarditis.
• Adhesions in pericardium causes friction during heart contraction and
thus gives frictional sounds.
 CIRCULATORY FUNCTION TESTS
• Blood Pressure
• The estimation of blood pressure has little value in animals because it is very difficult to retain
animal in a relax position.

• The blood pressure can be measured through direct and indirect methods:

• Direct method:
• In this method, the needle is inserted in a suitable artery, which is connected to mercury of
manometer.
• It gives only mean blood pressure of systolic and diastolic.

• Indirect method:
• In this method, the blood pressure is measured by using a sphygmomanometer which is having a
pneumatic cuff, that is fixed at the base of tail or in foreleg in horses and in hind legs in dogs.
• In normal dogs, the systolic pressure of coccygeal artery is 85-135 mmHg while that of
median artery it is 145-190 mmHg.

• The diastolic pressure is 40-70 mmHg of the coccygeal artery while it is 105-150 mmHg
in median artery.

• The systolic blood pressure of carotid artery in cattle is 120-190 mmHg while diastolic
pressure is 70-130 mmHg.

• Electrocardiography

• Electrocardiography provides an accurate diagnosis about the heart disease.

• Electrocardiography

• Electrocardiography provides an accurate diagnosis about the heart disease.

 Cardiac Diseases

• Developmental Defects

• Persistence of foramen ovale:

• Normally after birth, the foramen ovale between right and left atrium is closed. But
sometimes, it remains open and gives rise to hypertrophy of right ventricle, embolism
and cyanosis in calves.

• Persistence of interventricular foramen:

• The interventricular opening is responsible for increased blood pressure in ventricles,

pulmonary artery and hypertrophy of right ventricle which is manifested by a systolic
murmur.
 Cardiac Diseases
• Patent ductus arteriosus:
• The opening of pulmonary artery in aorta is present in fetal life, normally its closure occur after birth.
Sometimes it remains open and may cause hypertrophy of the right ventricle, characterized by cyanosis in
calves.

• Ectopia cordis:
• Heart is found outside the thoracic cavity either in neck region or in abdominal cavity, the condition is called as
ectopia cordis.

• Acardia:
• Acardia is the absence of heart in the animal.

• Diplocardia:
• In this condition, two hearts are present in an animal.
Abnormalities in Heart Rate
• Tachycardia:
• Tachycardia is the increased heart rate of an animal. The heart rate of animals is influenced by age,
temperature, excitation and due to diseases.

• Tachycardia is of two types:

• A. Simple tachycardia:
• It occurs due to excitement, pain, fever, temporary hypertension, increased venous pressure and due
to administration of adrenergic drugs.

• B. Paroxysmal tachycardia:
• It is a rare condition in animals; It occurs as sudden period of increased heart rates of shorter
duration. The heart sounds are also abnormal indicating a reduced blood volume. This condition is
observed in myocardial diseases.
 Abnormalities in Heart Rate

• . Bradycardia:
• Bradycardia is the diseased heart rate of an animal; It is of two types:

• a. Simple bradycardia:
• The heart rate is decreased due to stimulation of vagus nerve, increase in blood pressure,
hydrocephalus and other space occupying lesion in brain, postparturient hypocalcemia,
neonatal hypoglycemia of piglets, jaundice and traumatic reticulopericarditis.

• b. Heart block bradycardia:

• The decreased heart rate due to heart block occurs in animals. The interference in impulse is
responsible for heart contractions which are observed in myocarditis.
Heart Failure

• In this condition, the heart is unable to maintain the proper blood supply leading to
death of animal.

• Left sided heart failure:

• It occurs due to necrosis of myocardium, disease of aortic and mitral valve, hypertension
and some congenital defects are also responsible for left sided heart failure. In this
condition, the lungs are severely affected due to presence of more blood in pulmonary veins.
The increased pressure in pulmonary veins resulting in severe congestion of lungs. The
presence of “heart failure cells” in the lungs are characteristic feature of this type of cardiac
failure. The “heart failure cells” are the alveolar macrophages containing hemosiderin.
 Heart Failure

• Right sided heart failure:

• The right sided heart failure occurs due to occlusion of pulmonary artery which occurs in
pneumonia and other lung diseases. The secondary lesions develop in other body organs
rather than lungs. Increased venous pressure may be responsible for edema of subcutis,
jugular pulse and ascites.
Inflammatory and other Disease Conditions of Heart
• Endocarditis:
• Endocarditis is the inflammation of endocardium, the inner wall of heart.

• Myocarditis:
• Myocarditis is the inflammation of myocardium, the middle layer of the heart
wall.

• Pericarditis:
• Pericarditis is the inflammation of pericardium, the covering of heart.
Inflammatory and other Disease Conditions of Heart

• Hydropericardium:
• Hydropericardium is the accumulation of fluid in the pericardial sac.

• Pneumopericardium:
• Pneumopericardium is the accumulation of gases in the pericardial sac.

• Hemopericardium:
• Hemopericardium is the presence of blood in pericardial sac.

• The accumulation of blood in pericardial sac, sometimes, may cause cardiac failure; it is
known as cardiac tamponade
• Pyopericardium:
• Pyopericardium is the accumulation of pus in pericardial sac. It occurs in traumatic
pericarditis due to presence of pyogenic organisms.

• Brisket disease:
• In this condition, the edema of lower parts of body occurs particularly in brisket region
in high altitude native animals.

• Traumatic pericarditis:
• Since the cattle and buffaloes are not able to distinguish the metallic things in feed, they can
eat the sharp metallic objects like needles, nails, wires, etc. with feed. Such metallic objects
lodge in reticulum and with movements of stomach compartments, these may penetrate the
wall of reticulum and passes through diaphragm into pericardial sac causing pericarditis.
• Mulberry heart disease:
• Mulberry heart disease occurs in pigs due to suspected dietary deficiency and
characterized by sudden death due to cardiac failure, hydropericardium and
linear hemorrhages on heart giving the appearance of mulberries.

• Manchester wasting disease of cattle:

• This condition is also known as calcific arteriosclerosis, caused by
hypercalcemia and characterized by chronic wasting, stiffness of legs and back,
deposition of calcium in heart muscles, arteries, lungs and kidneys.
ACUTE HEART FAILURE

• ETIOLOGY
• Acute heart failure can occur when there is a severe defect in filling; when there is failure of the heart as a
pump, caused by severe tachycardia, bradycardia, or arrhythmia; and where there is a sudden increase in
workload.

• PATHOGENESIS
• With excessive tachycardia the diastolic period is so short that filling of the ventricles is impaired and cardiac
output is grossly reduced.
• In ventricular fibrillation no coordinated contractions occur and no blood is ejected from the heart.
• The cardiac output is also seriously reduced when the heart rate slows to beyond a critical point because
cardiac output is the product of heart rate and stroke volume and stroke volume cannot be markedly increased.
• In all these circumstances there is a precipitous fall in cardiac output and a severe degree of tissue ischemia.
 CLINICAL FINDINGS
• The animal usually shows dyspnea, staggering and falling, and
death often follows within seconds or minutes of the first
appearance of signs.

• Diagnosis-
• On the basis of history, clinical findings and clinical pathology.
CHRONIC (CONGESTIVE) HEART FAILURE-
• ETIOLOGY-
• Valvular Disease
• Endocarditis resulting in either valvular stenosis or valvular insufficiency

• Congenital valvular defects, most commonly valvular stenosis

• Rupture of valve or valve chordae

• Myocardial Disease
• Myocarditis: bacterial, viral, parasitic, or toxic

• Myocardial degeneration: nutritional or toxic

• Congenital or hereditary cardiomyopathy

• Toxins affecting cardiac conduction

• Congenital Anatomic Defects

• Producing Shunts
• Cardiac defects, such as ventricular or atrial septal defects, tetralogy of Fallot

• Vascular abnormalities producing shunts, such as patent ductus arteriosis

• Hypertension
• Pulmonary hypertension: high altitude disease, cor pulmonale

• Systemic hypertension: undocumented cause of congestive heart failure in large animals

• Pressure Load

• Volume Load

• Pumping Defects (Systolic Failure)

• Filling Defects (Diastolic Failure)
 PATHOGENESIS
• In the early stages of cardiac disease circulatory equilibrium may be maintained.

• However, cardiac reserve is reduced and the animal is not able to cope with circulatory emergencies as well as a
normal animal.

• This is the stage of waning cardiac reserve in which the animal is comparatively normal at rest but is incapable of
performing exercise (the phase of poor exercise tolerance) or responding appropriately to a physiologic stressor such
as late gestation or being housed in hot ambient temperatures.

• Congestive heart failure develops when these compensatory mechanisms reach their physiologic limit and the heart
is unable to cope with the circulatory requirement at rest.

• Failure may manifest as primarily being right-sided, left-sided, or both left-sided and right-sided.

• Many clinical signs that appear during the development of cardiac insufficiency, as well as those associated with
decompensated heart failure, are the consequence of congestion or edema caused by increased venous hydrostatic
pressure.

• A decreased cardiac output also contributes to the clinical signs by the production of tissue hypoxia.
CLINICAL FINDINGS
• The specific findings on auscultation.

• In the very early stages when cardiac reserve is reduced but decompensation has not yet occurred,
there is respiratory distress on light exertion.

• The time required for return to the normal respiratory and pulse rates is prolonged.

• In affected animals there may be evidence of cardiac enlargement and the resting heart rate is
moderately increased.

• There may be a loss of BW.

• Clinical signs of heart failure are predominantly right-sided in large animals, with the exception of
heart failure caused by mitral valve disease in horses and pulmonary edema in pigs caused by
fumonisin mycotoxicosis.
TREATMENT
• The treatment of animals with clinical signs of congestive heart failure caused by
pericarditis or pericardial tamponade focuses on removing the pericardial fluid and
preventing its return.

• In animals with pump failure, the treatment of congestive heart failure initially
focuses on the reduction of the effects of increased preload by administering
diuretic agents, angiotensin-converting enzyme (ACE) inhibitors, and restricting
sodium intake, reducing the demands on cardiac output by restricting activity, and
improving contractility by the administration of positive inotropic agents such as
cardiac glycosides and dobutamine.