Cardio Flashcards
what is wrong with ? 12 YO Bichon mix with hx of frequent cough, esp. at night, high RR and HR, crackles on lung fields, left systolic HM, and many B lines on all lung fields with LA:Ao >2:1.
MVD. note the alveolar pattern (can see bronchi), LA enlarged, sternal contact, the enlarged heart vessels, and the raised trachea (other causes of raised trachea are PCE, mediastinal mass, pleural effusion).
what is MVD
mitral valve disease = acquired myxomatous degeneration of left AVV causing mitral regurgitation (MR) and therefore systolic left-sided apex murmur; can take 4-6 years from murmur to CHF.
common! 80% of canine acquired heart disease
once left-sided acute CHF develops due to mitral valve disease, sinus arrhythmia disappears. why?
increased vagal tone causes sinus arrhythmia. when stressed, decreased vagal tone, so no sinus arrhythmia
what heart condition is most common in small/toy breeds, inherited in CKC Spaniels and male dachshunds? is early onset (3 years to CHF) and poorer prognosis in CKC Spaniels
mitral valve disease MVD
when do we start treatment for mitral valve disease?
MVD stage B2 (asymptomatic dogs with advanced MR and imaging showing left chamber enlargement)
they benefit from treatment to DELAY ONSET of CHF
what is the gold standard for MVD diagnosis
echocardiography to see contractility, leaky valve, LA and ventricular enlargement
other non gold standard: cardiac POCUS, brain natriuretic peptide, and thoracic radiographs
briefly describe tailored therapy for stage B2 MVD
pimobendan, ACEi, weight control diet +/- sodium reduction
(more details: pimobendan 0.25-0.3 mg/kg PO q12h
ACEi (benazepril, enalapril) if progressive left chamber enlargement
weight control diet and possible sodium reduction
controversially) cough suppressants
exam 2-4x year)
briefly describe chronic therapy for dogs with MVD post-CHF who have NOT had recurrent episodes
lower sodium diet and weight control, furosemide, pimobendan, and ACEi
(more details: furosemide 2 mg/kg PO q12h tapered to lowest possible dose, pimobendan 0.25-0.3 mg/kg PO q12h, ACEi (benazepril or enalapril 0.5 mg/kg PO q12-24h
labwokr and PE 1 week after start, then 1 month, then q3mo, with thoracic rads, and checking renal values and K+)
briefly describe chronic therapy for dogs with MVD post-CHF who HAVE had recurrent episodes
increase furosemide dosage beyond 2 mg/kg and add spironolactone (diuretic)
increase pimobendan to q8h dosage (0.25-0.3 mg/kg PO)
increase ACEi to q12h dosage (benazepril or enalapril 0.5 mg/kg PO)
strictly control weight, exercise, and low sodium diet
carefully monitor renal values to avoid cardio-renal syndrome
MVD post CHF prognosis: treatment with pimobendan and ACEi ______ survival after CHF, increasing dosage of furosemide _____ survival, and ruptured chord tendinae have ______ prognosis
increases; decreases; worse
asymptomatic phase of MVD lasts _____ years before progressing to CHF, and post-CHF survival time is ____ years
4-6; 1-2
what is pulmonary arterial hypertension often secondary to?
secondary to chronic lower airway disease, eg. pulmonary bronchitis or pulmonary fibrosis
what is wrong
PAH, pulmonary arterial hypertension. see large RV, RA, pulmonary artery.
lateral view showed enlarged LA and heart vessels. what is wrong?
DCM. this was lat view
what is dilated cardiomyopathy, DCM? what is it linked to?
acquired myocardial disease, cause unknown in most cases, but linked to certain GRAIN FREE DIETS. most common in large/medium breed dogs; it is autosomal recessive in Dobermans
what is hypertrophic cardiomyopathy
most common acquired heart disease in cats; left ventricular concentric hypertrophy; a myocardial disease that leads to reduced diastolic filling
