feedback cycle increases strain on the damaged heart muscle, predisposing the heart to acute heart failure and cardiac arrest. The clinical signs and symptoms of congestive heart failure are dependent on the location and severity of damage to the myocardium. Left side heart failure is seen as tachypnea or _______________ due to pulmonary edema, exercise intolerance, fatigue, vestibular ataxia, disorientation, cool extremities and ________________ . Right side heart failure is seen as pitted systemic edema, anascara, ascites, and enlargement of the liver, jaundice and visible distension of the _________________. Diagnosis of congestive heart failure can be made through the clinical signs and symptoms, the presence of a rapid and irregular heartbeat, rapid weight gain with anorexia, fluid retention, and depression. EKG may reveal areas of damage in the myocardium, or the presence of a defect in the heart or valves. Treatment of congestive heart failure includes, exercise and activity management, the restriction of ______________ intake, and drug therapies which include ACE inhibitors, Beta-blockers, vasodilators, diuretics and digitalis. Congestive heart failure is considered rare in horses, and prognosis is guarded to poor for survival and grave for a return to athletic activity.
Endocarditis
Endocarditis is defined as inflammation of the endocardium, the connective tissue lining of the heart chambers. Endocarditis is usually caused by ______________ of the heart valves or the endocardium with either Streptococcus spp . or Actinobacillus equi bacteria. In rare cases the infection is fungal in nature.
Transmission of the infection to the heart valves is through the circulation.
When the valves of the heart are infected there are clumps of bacteria attached to the valve flaps, which cause ______________ and obstruction of the blood flow, resulting in reduce flow and turbulence. The turbulent blood flow irritates the endocardium allowing bacteria to infect the endocardium at the sites of irritation. Infection and irritation of the endocardium results in the increased production of endocardial __________________, which restricts the proper contraction of the myocardium. The infection may spread from the heart, through the blood stream, to other organs such as the kidneys, lungs or brain. Horses with internal parasite infestations or systemic bacterial infections are at higher risk of developing endocarditis. Horses on systemic antibiotics are at increased risk of developing GIT
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