6. myxomatosus mitral valve disease

Question 1

mitral valve disease general

Answer 1

most common heart disease of dogs
older age, male>female
King Charles, poodle

Question 2

pathomechanism

Answer 2

remodeling and compromised structural component of mitral valve

• TGF beta, increased serotonin levels
• loss of collagen fibres
• knotting, thickening, distorted edges
• thick/ruptured chords tendinea
• dilated mitral ring
• eccentric hypertrophy - volume overload

Question 3

clinical consequence

Answer 3

valve don’t close properly due to knots, ruptured chords
mitral valve prolapse, mitral insufficiency
volume overload -> eccentric hypertrophy
increased V. pulmonary pressure -> pulmonary edema
-> respiratory distress

Question 4

physical exam

Answer 4

systolic heart murmur

signs of left sided heart fail

Question 5

grading system

ACVIM consensus

Answer 5

A: high risk but no identifiable structural disorder
B1: asymptomatic, no remodeling
B2: asymptomatic, REMODELING
C: clinical signs, structural disease visible
D: end stage disease, clinical signs of heart failure

Question 6

treatment of asymptomatic cases

Answer 6

B2 only

pimobendane: vasodilator, Ca- sensitizer

Question 7

treatment in case of clinical signs

Answer 7

category C and D
pimobendane
loop diuretic: furosemide, torsemide
ACE inhibitor: spironolactone

Question 8

complications

Answer 8

pulmoinary hypertension: treat with sildenaptil

left atrial tear