Acquired Heart Diseases: Degenerative Mitral Valve Disease Flashcards
_________ is the most common acquired heart disease in dogs
Degenerative valve disease
Other names:
- Myxomatous valve disease
- Endocardiosis
- Chronic valvular disease
What is the most common valve affected in degenerative valvular disease?
Mitral valve
(Tricuspid is 2nd most affected valve)
Degenerative mitral valve disease leads to _______ overload and _______ hypertrophy
Volume, eccentric
- Results in mitral valve regurg, LA + LV dilation, vol overload, and eccentric hypertrophy
Degenerative mitral valve disease has a genetic tendency in which breeds?
Cavalier king charles spaniel
+ other small purebred dogs
Define stage B1 DMVD
Patient has degenerative valves and mitral valve regurg, but presents asymptomatic with no evidence of cardiac remodeling (cardiomegaly)
Define stage B2 DMVD
Patient has degenerative valves, mitral valve regurg, and evidence of cardiac remodeling (L sided cardiomegaly), but presents asymptomatic
Define Stage C DMVD
Symptomatic patient with degenerative valves, mitral regurg, evidence of cardiac remodeling (L sided cardiomegaly)
- Showing CS of heart failure
Define Stage D DMVD
Patient with end stage disease and CS of heart failure, refractory to tx
Define Stage A DMVD
Patient at high risk of developing
(Cav king charles without a murmur)
Degenerative mitral valve disease is more common in __________ (males/females)
Males
A __________ murmur is usually the 1st clue a patient may have degenerative mitral valve disease
Left apical systolic murmur
Murmur grade correlates with severity of regurg!
Some dogs with DMVD may have a _______ (heart sound) with or without a murmur
Mid systolic click (between S1 and S2)
True or False: Dogs with Stage B1 or B2 DMVD present with normal HR, respiratory rate, and femoral pulses
TRUE!
Asymp pet in B1 and B2
Diagnostic workup in a patient with DMVD?
- Thoracic rads (check for evidence of L sided cardiomegaly)
- BP (want to avoid systemic hypertension which would cause pressure overload in LV and worse regurg)
- Echo for definitive diagnosis (staging B1 vs B2)
IMPT
Degenerative mitral valve disease is more common in _________ (males/females)
Males
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
B. Thoracic rads
(If presenting with CS of DMVD= Stage C, no time to wait for echo)
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
C. Echocardiogram
(no CS so you can wait for the echo)
True or False: Patients with DMVD often present with a low blood pressure
False
Normotensive and normothermic
How does a patient with Stage C DMVD typically present?
- Left apical systolic murmur, often high grade
- Tachypnea (RR > 35 breaths/min)
- Abnormal lung sounds (crackles)
- Normal HR and BP
- Collapse or syncope
What is the criteria for diagnoses CHF due to DMVD?
- L-sided cardiomegaly + LA enlargement
- Interstitial pulmonary infiltrates, +/- alveolar infiltrates
- Enlargement of the cranial and/or caudal pulmonary vein (not always present)
What blood test can be done to differentiate cardiac vs non-cardiac causes of respiratory signs in cases of suspect DMVD?
B-type natriuretic peptide (BNP)
What stage of DMVD first warrants treatment?
A. Stage A
B. Stage B1
C. Stage B2
D. Stage C
C. Stage B2
What is the treatment protocol for a patient diagnosed with Acute Stage C DMVD?
- Furosemide IV/IM
- Pimobendan
- +/- supplemental O2
What is the treatment protocol for a patient diagnosed with Stage B2 DMVD?
- Pimobendan PO
- Mild dietary sodium restrictions
