6. Myxomatous mitral valve diseases Flashcards

1
Q

what is Myxomatous Mitral Valve Disease

A

characterised by progressive degeneration of the mitral valve which can lead to mitral regurgitation & subsequent left atrial & ventricular dilation

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2
Q

other names for Myxomatous Mitral Valve Disease

A

Acquired mitral regurgitation
Mitral valve insufficiency
Atrioventricular valvular degeneration
Endocardiosis
Chronic Mitral Valve Disease
Mitral Valve degeneration
Degenerative valvular disease

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3
Q

Cause of Myxomatous Mitral Valve Disease

A

unknown

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4
Q

predisposition of Myxomatous Mitral Valve Disease

A

Increase with age
small breeds
male > female

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5
Q

Pathophysiology of Myxomatous Mitral Valve Disease

A

valvular interstitial cells behave like activated myofibroblasts
Proteolytic enzymes degrade valvular collagen and elastin

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6
Q

2 pathways responsible for Myxomatous Mitral Valve Disease

A

Serotonin
TGF - Beta

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7
Q

what does regurgitation cause

A

increased cardiac workload and volume overload

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8
Q

consequences of Myxomatous Mitral Valve Disease

A

Mitral valve prolapse
Mitral insufficiency
Pulmonary oedema
LA & LV diilation - eccentric ventricular hypertrophy
Increased LA, pulmonary vein pressure
Pulmonary hypertension

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9
Q

Diagnosis of Myxomatous Mitral Valve Disease

A

systolic murmur
left sided HF
+/- right sided HF
lung oedema, chamber enlargement - xray
echo

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10
Q

normal LA: Aorta ratio

A

1:1

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11
Q

LA: Aorta ratio in case of HF

A

> 2/7:1

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12
Q

Stage A MMVD

A

All patients at risk for developing heart disease
no current apparent structural abnormality
No murmur
No treatment

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13
Q

Stage B1 MMVD

A

Asymptomatic patients with no evidence of cardiac remodelling

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14
Q

Stage B2 MMVD

A

Asymptomatic patients with evidence of cardiac remodelling

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15
Q

Stage C MMVD

A

Dogs with MMVD and clinical signs of HF
responsive to standard HF therapy

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16
Q

Stage D MMVD

A

Dogs with end stage MMVD and clinical signs of HF
Refractory to standard HF therapy

17
Q

Treatment of stage B1&2

A

Ace inhibitors
Pimobendan
Spironolactone
Beta blockers

18
Q

Treatment of acute stage C& D

A

furosemide
pimobendan
spironolactone
ace inhibitors

19
Q

Treatment of chronic stage C& D

A

furosemide
O2
ventilation
pimobendan
ace inhibitors

20
Q

Differential diagnosis of MMVD

A

dirofilariasis
tricuspid valve dysplasia

21
Q

Complications of MMVD

A

pulmonary hypertension
arrhythmia
left atrial tear

22
Q

what can be seen in an echo of MMVD

A

regurgitation
artial and ventricular dilation
thickening of valves
rupture of chordae tendinae

23
Q

ECG of Ventricular myocardial lesions & CHF

A

Ventricular premature beat & sinus tachycardia

24
Q

ECG of Left atrial enlargement

A

atrial premature complexes

25
Q

ECG of Left atrial & ventricular enlargemen

A

Tall & widened R-wave; Widened P-wave

26
Q
A