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SEM 5: SAM 1 > Acquired Heart Diseases: Degenerative Mitral Valve Disease > Flashcards

Acquired Heart Diseases: Degenerative Mitral Valve Disease Flashcards

1
Q

_________ is the most common acquired heart disease in dogs

A

Degenerative valve disease

Other names:
- Myxomatous valve disease
- Endocardiosis
- Chronic valvular disease

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2
Q

What is the most common valve affected in degenerative valvular disease?

A

Mitral valve

(Tricuspid is 2nd most affected valve)

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3
Q

Degenerative mitral valve disease leads to _______ overload and _______ hypertrophy

A

Volume, eccentric

  • Results in mitral valve regurg, LA + LV dilation, vol overload, and eccentric hypertrophy
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4
Q

Degenerative mitral valve disease has a genetic tendency in which breeds?

A

Cavalier king charles spaniel

+ other small purebred dogs

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5
Q

Define stage B1 DMVD

A

Patient has degenerative valves and mitral valve regurg, but presents asymptomatic with no evidence of cardiac remodeling (cardiomegaly)

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6
Q

Define stage B2 DMVD

A

Patient has degenerative valves, mitral valve regurg, and evidence of cardiac remodeling (L sided cardiomegaly), but presents asymptomatic

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7
Q

Define Stage C DMVD

A

Symptomatic patient with degenerative valves, mitral regurg, evidence of cardiac remodeling (L sided cardiomegaly)

  • Showing CS of heart failure
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8
Q

Define Stage D DMVD

A

Patient with end stage disease and CS of heart failure, refractory to tx

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9
Q

Define Stage A DMVD

A

Patient at high risk of developing

(Cav king charles without a murmur)

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10
Q

Degenerative mitral valve disease is more common in __________ (males/females)

A

Males

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11
Q

A __________ murmur is usually the 1st clue a patient may have degenerative mitral valve disease

A

Left apical systolic murmur

Murmur grade correlates with severity of regurg!

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12
Q

Some dogs with DMVD may have a _______ (heart sound) with or without a murmur

A

Mid systolic click (between S1 and S2)

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13
Q

True or False: Dogs with Stage B1 or B2 DMVD present with normal HR, respiratory rate, and femoral pulses

A

TRUE!

Asymp pet in B1 and B2

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14
Q

Diagnostic workup in a patient with DMVD?

A
  1. Thoracic rads (check for evidence of L sided cardiomegaly)
  2. BP (want to avoid systemic hypertension which would cause pressure overload in LV and worse regurg)
  3. Echo for definitive diagnosis (staging B1 vs B2)

IMPT

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15
Q

Degenerative mitral valve disease is more common in _________ (males/females)

A

Males

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16
Q

What is the gold standard for diagnosing DMVD in a symptomatic patient? The owner can only afford 1

A. Blood pressure
B. Thoracic rads
C. Echocardiogram

A

B. Thoracic rads

(If presenting with CS of DMVD= Stage C, no time to wait for echo)

17
Q

What is the gold standard for diagnosing DMVD in an asymptomatic patient? The owner can only afford 1

A. Blood pressure
B. Thoracic rads
C. Echocardiogram

A

C. Echocardiogram

(no CS so you can wait for the echo)

17
Q

True or False: Patients with DMVD often present with a low blood pressure

A

False

Normotensive and normothermic

18
Q

How does a patient with Stage C DMVD typically present?

A
  • Left apical systolic murmur, often high grade
  • Tachypnea (RR > 35 breaths/min)
  • Abnormal lung sounds (crackles)
  • Normal HR and BP
  • Collapse or syncope
19
Q

What is the criteria for diagnoses CHF due to DMVD?

A
  1. L-sided cardiomegaly + LA enlargement
  2. Interstitial pulmonary infiltrates, +/- alveolar infiltrates
  3. Enlargement of the cranial and/or caudal pulmonary vein (not always present)
20
Q

What blood test can be done to differentiate cardiac vs non-cardiac causes of respiratory signs in cases of suspect DMVD?

A

B-type natriuretic peptide (BNP)

21
Q

What stage of DMVD first warrants treatment?

A. Stage A
B. Stage B1
C. Stage B2
D. Stage C

A

C. Stage B2

22
Q

What is the treatment protocol for a patient diagnosed with Acute Stage C DMVD?

A
  1. Furosemide IV/IM
  2. Pimobendan
  3. +/- supplemental O2
23
Q

What is the treatment protocol for a patient diagnosed with Stage B2 DMVD?

A
  1. Pimobendan PO
  2. Mild dietary sodium restrictions
24
Q

What stage of DMVD warrants a diet change restricting sodium intake?

A

Stage B2

25
Q

What is the treatment protocol for a patient diagnosed with Acute Stage C DMVD?

A
  1. Furosemide PO
  2. Pimobendan
  3. ACE inhibitor
  4. Spironolactone

(core 4 for chronic CHF in dogs)

26
Q

True or False: Isolated degenerative tricuspid valve disease is uncommon

A

True

27
Q

What cardiac biomarker is used to help diagnose DMVD?

A. Atrial natriuretic peptide
B. B-type natriuretic peptide
C. Cardiac troponin I
D. N-terminal proBNP

A

B. B-type natriuretic peptide

SEM 5: SAM 1 (35 decks)

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