Acquired murmurs in dogs Flashcards
Definition of Acquired
Not present at birth and acquired during life
Though it may be caused by genetic factors
Definition of a Murmur and name some causes
Abnormal heart sound caused by turbulent blood flow
Valvular incompetency
Stenosis
Abnormal connection (Ventricular septum defect)
Examples of Endocardial disease
Endocardiosis/Degenerative mitral valve disease/myomatous mitral valve disease
Endocarditis
Examples of Myocardial disease
Dilated cardiomyopathy (Primary or secondary)
Arrhythmic right ventricular cardiomyopathy
Hypertrophiccardiomyopathy (Primary or secondary)
Myocarditis
What is the most common disease relating to the heart for dogs
Endocardial disease- Degenerative mitral valve disease
What dog breed is predisposed to have degenerative mitral valve disease
Cavalier Kings Charles Spaniel
What are the likelihoods of the different valves will be affected by MMVD
Mitral (Left AV)- 95%
Tricuspid valve- 35%
Aortic valve- 3%
Outline pathophysiology of DMVD
- Valve leakage
- Eccentric hypertrophic of left ventricle
- Volume overload of left ventricle
- Decreased CO
- Stimulation of RAAS
- Left atrial enlargement
- Pulmonary hypertension
- Right side CHF
Clinical finding of a cough is common in dogs or cats in Endocardial disease
Dogs!
Clinical signs of Endocardial disease/DMVD in dogs
Asymptomatic
Signs of left sided cardiomegaly- Cough
Signs of LCHF- Tachypnoea/Dyspnoea due to pulmonary oedema/Cough/Excersise intolerance
Signs if RCHF- Ascites/Dyspnoea due to pleural effusion
T/F Clinical examination can determine which valve is affected by DMVD
True!
T/F Murmur grade is related to severity of disease
True!
Outline the ACVIM Modified ACC
Classification used to guide treatment
A- Predisposed
B1- Asymptomatic/No Cardiomegaly
B2- Asymptomatic/Cardiomegaly
C- Current of previous CHF
D- Refractory CHF
What valves does bacterial endocarditis frequently affect the most for dogs/cats/horse
Valves on left side
Aortic valve the most common
Mitral second most
State the defect that predisposed dogs to develop endocarditis
Congenital Aortic Stenosis
What valves does bacterial endocarditis frequently affect the most for cattle
Valves on right side
Clinical presentations of endocarditis
Pyrexia
Joint pain and stiffness/Lameness
New left sided murmur
Diagnosis for endocarditis
Blood culture
Urine culture
Joint taps
Echocardiography
Thoracic radiology
Abdominal ultrasonography
Haematology
Treatment for endocarditis
Antibiotics
Supportive therapy
Prevention for endocarditis for dogs with with severe aortic stenosis
Treat with prophylactic antibiotics if undergoing routine dental treatments/or if they have wounds
What is the most common myocardial disease in dogs
- Dilated Cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy
T/F Hypertrophic cardiomyopathy is common in dogs
False!
T/F Myocarditis is common in dogs
False ( Probably under diagnosed)
Aetiology of DCM in dogs (Primary)
Idiopathic
Hereditary
Breeds of dogs predisposed to DCM
Doberman/Irish wolfhounds/Boxer
Aetiology of DCM in dogs (Secondary)
Toxic-doxorubicin (Chemo)
Tachycardia induced
Dietary- Taurine/Carnitine/Grain deficiency
Pathophysiology of DCM
- Systolic failure
- Poor CO=Exercise intolerance
- Stimulation of RAAS-Fluid retention-L/RCHF
- Dilation of left ventricle
- Ventricular arrhythmias
- Sudden death
T/F Females are predisposed to DCM in dogs
False! Males more often
Clinical signs for DCM in dogs
Exercise intolerance
RSCHF>LSCHF
R: Pleural effusion/Ascites
L: Cough/Dyspnoea/Tachypnoea/Exercise Intolerance
Meaning of syncope
Loss of consciousness
Difference in clinical signs between DCM and DMVD
DCM- Weak pulse/Poor capillary refill time/Pallor
Meaning of pallor
Pale colour of MM
What is the normal ratio of the size of left ventricle to aorta in ultrasound
Normal: <1.5
State the mutation in the genes of dobermans that predispose them to DCM
PDK4 Mutation and Tintin mutation
T/F DCM is a progressive disease
True!
T/F DMVD is a not progressive disease
False!
Average survival after onset of congestive heart failure
Doberman: <9months
Average: 6-18 months
T/F Dilated cardiomyopathy may be present in an ‘occult’ form for several years before CHF develops
True!
Name the drugs to treat to Ventricular arrhythmias in dogs
Solatol
Mexiletine
Amiodarone
Name the drugs to treat fast atrial fibrillation in dogs
Digoxin
Diltiazem
Atenolol
Solatol is used to treat?
Ventricular arrhythmias
Digoxin is used to treat?
Atrial fibrillation
Name the drug used to manage early stage DCM
Pimobendan
What dog breeds are predisposed to Arrhythmogenic right ventricular cardiomyopathy
Boxers and Bulldogs
What cat breeds are predisposed to Arrhythmogenic right ventricular cardiomyopathy
None!
Management of ARVC
Support systolic function with pimobendan
Reducing further remodelling with ACE inhibitors
Treat life threatening ventricular arrhythmias with solatol
State criteria for treating ventricular arrhythmias
Runs of ventricular tachycardia >180bpm
Multiform VPCs- Coming from different places
Close coupling of ventricular ectopic
Clinical findings of myocarditis in dogs
Not specific to cardiac disease
Secondary to infection/neoplasia
Arrhythmias common
Ventricular arrhythmias may be multi focal
Pyrexia
Diagnosis of myocarditis and name the specific protein tested
High serum troponin 1
Myocardial biopsy
Rising titres on serology
T/F Sudden cardiac death is common for myocarditis
True!
