Cardio - DMVD Flashcards
What is the most common heart disease in dogs?
Degenerative Mitral Valve Disease (DMVD)
What is DMVD?
Progressive, age-related degeneration of the heart valves that results in valve regurgitation, progressive heart dilation, and ultimately results in CHF.
What valves are most commonly to least commonly affected in DMVD?
Mitral > tricuspid > aortic >> pulmonic (dogs)
What are some other names for DMVD?
Degenerative Valve Disease (DVD)
Myxomatous Mitral Valve Disease (MMVD)
Chronic Valvular Heart Disease (CVHD)
Endocardiosis
What is the etiology of DVMD?
- Myxomatous degenerative valve apparatus changes
- Thickening of valve and chordae tendinae
- Regurgitation
Valvular regurgitation is a _____ overload disease.
volume
What pathophysiology is caused by DMVD?
- Valvular regurgitation is a volume overload disease
- Excess volume in the ventricle results in eccentric hypertrophy and dilation
- Complications of progressive disease: L-CHF, arrhythmias, atrial rupture
What is the common signalment for DMVD?
Dogs (more common) and horses, middle aged to older, male > female;
Small-medium sized dogs more common
Breeds: CKCS, mini poodle, Schanuzers, Fox terriers, Pomeranian, Yorkie, Chihuahua, Dachshund
What happens in stage A of HF?
At risk breeds and/or signalment with no murmur
What happens in stage B1 of HF?
Degenerative valve changes –> regurgitation and a murmur (L apical systolic regurgitant) with normal heart size or mild L atrial dilation
What happens in stage B2 of HF?
Murmur with moderate or severe LA dilation
What happens in stage C of HF?
Progression to CHF, can have concurrent arrhythmias and/or multiple episodes of CHF
(Heart dilated, fluid starting to back up into lungs)
What happens in stage D of HF?
Episode of CHF that is refractory to tx
What is the presentation of stage A?
Asymptomatic, no murmur
What is the presentation of stage B1?
Asymptomatic, murmur and/or mid-systolic click, normal rads or mild LA dilation
What is the presentation of stage B2?
Asymptomatic or symptoms of cough, exercise intolerance;
Murmur with moderate-severe LA dilation on rads
What is the presentation of stage C?
Signs of CHF - soft cough, increased RR and effort, weakness, exercise intolerance, collapse, restlessness at night, weight loss, reduced appetite;
Murmur, tachycardia, crackles, +/- arrhythmia and/or pulse deficits;
Moderate-severe L cardiomegaly and pulmonary edema on rads
What is the presentation of stage D?
Same as stage C often with cachexia and/or hypotension;
Tx requires hospitalization and more advanced CHF therapies
What diagnostics can be done in GP to assess HF/DMVD?
Thoracic rads, BP, +/- labs (chem, U/A, NT-proBNP), +/- echo, +/- ECG
What stage of DMVD is shown here?
Appears normal due to normal silhouette but is stage B1
(may sometimes have mild LA dilation)
What stage of DMVD is shown here?
B2 - moderate LA enlargement
What stage of DMVD is shown here?
C;
Moderate to severe LA dilation, pulmonary venous dilation, interstitial to alveolar pattern
What is the definitive diagnostic for DMVD?
Echocardiogram
What echo findings are consistent with stage B1 DMVD?
Thickened valve leaflets with mitral regurgitation
Normal heart size or mild LA dilation
