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SAM 1 > Degenerative Valve Disease > Flashcards

Degenerative Valve Disease Flashcards

1
Q

what is the most common acquired heart disease in dogs?

A

degenerative valve disease (usually mitral)

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2
Q

chronic valvular disease, myxomatous valve disease, and endocardiosis are common names for what disease?

A

degenerative valve disease

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3
Q

what valve is most commonly affected by degenerative valve disease?

A

mitral

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4
Q

T/F: 70% DMVD will be symptomatic and could result in sudden death

A

FALSE, asymptomatic

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5
Q

what breed has a genetic tendency of DMVD?

A

cavalier King Charles spaniel

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6
Q

what is commonly affected in addition to the leaflets in DMVD?

A

chordae tendineae >ACUTE (no time for compensatory hypertrophy)

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7
Q

in patients with DMVD what accumulates in affected valves and makes them thicker?

A

glycosaminoglycans

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8
Q

T/F: dogs with CHF due to DMVD have arteriosclerosis of intramural coronary arteries and myocardial fibrosis

A

TRUE

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9
Q

malformed leaflets lead to what?

A

valvular regurgitation > +/- reduced CO

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10
Q

is DMVD progression acute or chronic in most dogs?

A

chronic, occurs over several years

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11
Q

name this stage: high risk developing heart dz with no identifiable structural disorder

A

stage A

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12
Q

name this stage: structural heart dz but no clinical signs caused by HF

A

stage B

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13
Q

name this stage: asymptomatic patients with no evidence of cardiac remodeling

A

stage B1

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14
Q

name this stage: asymptomatic patients with hemodynamically significant valve regurg, evidence of left-sided heart enlargement

A

stage B2

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15
Q

name this stage: patients with past or current clinical signs of HF assoc. with structural heart dz

A

stage C

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16
Q

name this stage: end-stage dz, clinical signs of HF caused by DVD, refractory to “standard therapy”

A

stage D

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17
Q

T/F: DMVD is more common in LBD

A

FALSE, small-medium breeds

18
Q

T/F: middle-aged to older dogs are more affected by DMVD

A

TRUE, EXCEPT: cavalier King Charles

19
Q

what is your first clue in a patient who might have DMVD?

A

left apical systolic murmur (often correlated with severity of valve regurg)

20
Q

sometimes dogs with DMVD have a mid-systolic click…what is the cause of this?

A

result of the valve prolapsing

21
Q

what tests are considered the gold standard in diagnosing DMVD?

A

CBC, chem, UA, echocardiogram

22
Q

your client can’t afford the gold standard testing to diagnose DMVD…what is the minimum lab work you could do instead?

A

PCV or HCT & TS, serum creatinine, UA

23
Q

in what patients should echocardiography be prioritized to rule out DCM?

A

LBD

24
Q

patients that are “diuretic dependent” and have L-CHF are considered to be in what stage?

A

stage C

25
Q

the signs below are criteria for the diagnosis of what on thoracic radiographs?

  1. left-sided cardiomegaly (mod-severe LA enlargement)
  2. interstitial +/- alveolar pulmonary infiltrates
  3. enlargement of cranial and/or caudal pulmonary veins
A

L-CHF

26
Q

where in the lungs does edema tend to start and then spread in a dog with L-CHF?

A

begins in peri-hilar region/caudodorsal lung field > cranially and ventrallly

27
Q

what can be a clue in helping differentiate primary respiratory dz vs patient with stage C DMVD?

A

primary respiratory dz tends to have normal HR whereas DMVD will have high-normal to tachycardia due to compensation involving increase SNS tone

28
Q

what cardiac biomarker is most commonly measured in the diagnosis of DMVD?

A

B-type natriuretic peptide (BNP)

also can measure atrial natrietic peptide (ANP) and cardiac troponin I (cTnl)

29
Q

what cardiac biomarker reflects myocyte damage and death?

A

cardiac troponin I

30
Q

what two drugs are used in dogs with stage B2 DMVD?

A

ACE inhibitors and pimobendan

31
Q

what drugs are used in the acute treatment of dogs with stage C DMVD?

A

furosemide (IV/IM), pimobendan (PO), +/- butorphanol for sedation of anxious patients, +/- topical nitroglycerin

32
Q

what drugs are used in the acute ICU treatment of dogs with stage C DMVD and severe pulmonary edema?

A

nitroprusside CRI, dobutamine CRI if relevant systolic dysfunction

33
Q

what drugs are used in the chronic treatment of dogs with stage C DMVD?

A

furosemide, pimobendan, +/- ACE inhibitor (benazepril or enalapril), spironolactone 1-2 weeks after starting ACE inhibitor

34
Q

what two drugs used in the treatment of chronic stage C DMVD would be contraindicated with GI upset (i.e. V/D)?

A

ACE inhibitors (benazepril or enalapril) and spironolactone

35
Q

in addition to the four standard drugs used to treat chronic stage C DMVD, what other drugs might you consider in treatment of stage D DMVD?

A

HCTZ, torsemide, SC furosemide, vasodilators, synthetic ADH or BNP

36
Q

what can clients do at home to monitor their dogs with DMVD that is a reliable indicator of L-CHF?

A

at-home sleeping/resting respiratory rate

subclinical or well-controlled CHF: <30 breaths per minute at home

stage C: monitor daily
stage B2: monitor weekly

37
Q

what is the second most common degenerative valve disease in dogs?

A

degenerative tricuspid valve disease

38
Q

what clinical signs would you see in a patient with DTVD?

A

R-CHF: abdominal distension (hepatic congestion and ascites), tachypnea/dyspnea/cough (large volume of pleural effusion> uncommon), exercise intolerance

right +/- left apical systolic murmur
high-normal HR or tachycardia
+/- tachypnea/dyspnea/cyanosis

39
Q

T/F: isolated DMVD is uncommon

A

FALSE, DTVD

40
Q

in addition to treatment as described in dogs for DVD, what additional treatment is indicated in cats?

A

anticoagulant and thoracocentesis (can have pleural effusion in both L & R-CHF)

41
Q

T/F: DVD in cats is much less common than dogs and is slower to progress

A

TRUE

SAM 1 (19 decks)

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