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Cardiovascular Pathophysiology > Heartworm Disease Part I > Flashcards

Heartworm Disease Part I Flashcards

1
Q

what is the definitive host of Dirofilaria immitis?

A

dog

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2
Q

what is the infective stage of Dirofilaria immitis?

A

L3 larvae

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3
Q

what is class I of heartworm disease?

A

evidence of disease absent or mild
usually identified by routine screening

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4
Q

what is class IV of heartworm disease?

A

caval syndrome

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5
Q

what is class III of heartworm disease?

A

severe heartworm disease
typically with cor pulmonale

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6
Q

“heartworm” is rpimarily a disease not of the hart but of the _____________________

A

pulmonary arteries

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7
Q

when do vascular changes occur with heartworm disease?

A

within 3 weeks of adult heartworm transplantation

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8
Q

what on pathology is pathognomonic of dirofiliriasis?

A

villous endarteritis

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9
Q

what is villous endarteritis?

A

proliferation of smooth muscle cells of tunica media
migration of smooth muscle cells to intima and production of villi

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10
Q

what is a common complication of adulticide therapy 1-3 weeks after treatment?

A

adult worm death catastrophic consequences

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11
Q

why can pulmonary thromboembolism occur with heartworm disease independently of worms?

A

platelet activation
endothelial damage
chronic inflammation
glomerulonephropathy
blood stasis

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12
Q

why can chronic pulmonary arterial disease result in cor pulmonale?

A

leads to pulmonary hypertension which leads to right ventricle pressure overload
this leads to right ventricle hypertrophy and right sided heart failure eventually

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13
Q

what do microfilariae sequestered in the lungs cause?

A

intense eosinophilic infiltration

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14
Q

what is happening in caval syndrome?

A

heartworms are present within the heart

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15
Q

what does eosinophilic infiltration from microfilariaee sequestered in the lungs look like on chest radiographs?

A

diffuse interstitial to alveolar infiltrates
can progress to granulomatous-type reactions- looks like metastases

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16
Q

what does caval syndrome require?

A

immediate surgical removal of adults

17
Q

what can cause glomerular disease from heartworm disease?

A

immune-mediated glomerulonephropathy: immune complexes
low cardiac output

18
Q

when can disseminated intravascular coagulation happen with heartworm disease?

A

endothelial damage with severe disease
caval syndrome
especially post-adulticide

19
Q

what can increase the host immune response to Dirofilaria immitis?

A

Wolbachia organisms

20
Q

what are Wolbachia organisms?

A

obligate, intracellular gram negative bacteria
critical for certain stages of filarial life cycle

21
Q

what decreases pulmonary pathology associated with adulticide?

A

pre-treatment with doxycycline and ivermectin

22
Q

what are aberrant heartworm infections characterized by?

A

ectopic migration of larvae

23
Q

are cats resistant to heartworm disease compared with dogs?

A

yes: 10% or canine infection rate

24
Q

how often are cats microfilaremic?

A

rarely

25
Q

what is feline heartworm-associated respiratory disease often confused with?

A

feline asthma

26
Q

what is important when considering a cat with heartworm compared to a dog?

A

cats have smaller pulmonary artery trees: embolizations, even small ones, can have disastrous effects

27
Q

what are consistent findings of feline heartworm disease?

A

dyspnea and cough

28
Q

what is class II of heartworm disease?

A

moderate disease with coughing and exercise intolerance but no heart failure
radiographic changes evident

29
Q

what cells contribute acutely to pulmonary arterial disease?

A

neutrophils
eosinophils

30
Q

what can adult worm death cause?

A

embolization: thrombosis, inflammatory
pulmonary infarction, acute R-sided CHF, respiratory failure, vascular rupture

31
Q

why can pulmonary thromboembolism occur with heartworm disease?

A

death of adult worms: thrombus
hypercoagulable state

32
Q

what can microfilariae sequestration in the lungs result in?

A

occult infections: no circulating microfilariae

33
Q

where might adult worms be present in caval syndrome?

A

right ventricle
right atrium
vena cavae
hepatic veins

34
Q

what does research show with Wolbachia organisms and heartworm disease?

A

targeting Wolbachia in addition to D. immitis may greatly decrease pathology and improve outcome

35
Q

when might a systemic arterial thrombosis occur with aberrant heartworm infections?

A

if L5 stage migrates into arterial system

Cardiovascular Pathophysiology (35 decks)

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