Cardio - Staging of Heart Disease Flashcards
What is functional staging of heart disease based on?
How the patient feels
What are the 2 types of functional classifications?
NYHA and ISACHC - patients can move forward OR backward through the classes
What is structural staging of heart disease based on?
What the heart looks like
What is the type of structural staging we use and what is it designed for?
ACC/AHA classification (adopted by ACVIM) - patients can only move forward thru classes;
Designed for DMVD
What is stage A of HD?
NOT actually disease!
Breeds that are at risk but that do not show any signs or structural abnormalities
What are the recommendations for patients in stage A?
Annual PE and auscultation, CE, no medical tx, no dietary restrictions
What breeds are predisposed to HD?
Dobermans, Cavalier King Charles Spaniels
What is stage B of HD?
There is structural disease present, along with a heart murmur OR imaging evidence (echo, xrays);
NO clinical signs!
What is stage B1 of HD?
What are the recommendations?
No hemodynamic compromise; None-mild heart enlargement
Rec = No medical tx or dietary restrictions, annual monitoring
What is stage B2 of HD?
What are the recommendations?
Relevant hemodynamic compromise, significant heart enlargement (echo or rads), DMVD - cutoffs for LA and LV size
Rec = ACEi, Pimobendan
What is the earliest stage for DCM?
B2
Why are ACEi and Pimobendan indicated for stage B2?
To delay progression to CHF
Why are furosemide and spironolactone not indicated for stage B2?
There is no evidence of CHF
What is stage C of HD?
What are the recommendations?
CHF - current or past signs; L-sided = pulm edema, R-sided = cavitary effusions
Rec = Furosemide, Pimobendan, ACEi, spironolactone, dietary Na restriction, +/- others
What is stage D of HD?
What are the recommendations?
Current or past signs of CHF refractory to “standard tx” (furosemide high-dose, pimobendan, ACEi, spironolactone);
Rec = increase furosemide dose, increase pimobendan dose, amlopidine, hydrochlorothiazide, +/- anti-arrhythmics, +/- sildenafil
