Degenerative Valvular Disease

Question 1

In which species is degenerative valvular disease most common in ?

Answer 1

In dogs

Question 2

What is degenerative valvular disease characterised by?

Answer 2

• Accumulation of mucopolysaccharides on the AV valve leaflets
• most importantly the mitral valve
• leaflets become abnormally thick and nodular in appearance
• chordae tendonae tend to lengthen
• Consequnce: mitral valve regurgitation = vol. overload of the left atrium and ventricle = eccentric hypertrophy and LEFT sided heart failure
• Tricuspid valve can be affected as well = right sided heart failure

Question 3

Drugs to treat degenerative valvular disease

Answer 3

• ACE inhibitors in degerative valvular disease
• used for vasodilatory effects and inhibition of aldosterone
• Calcium channel blockers (slows sinus rate)
• Nitrates (nitroglycerin and nitroprusside) in acute settings
• Diuretics -when pulmonary edema is present
• Use of hydralazine (vasodilator) or amlodipine ( ca channel blocker/dilator) - for patients with advanced/refractory CHF