Hypertrophic Cardiomyopathy and Other Feline Myocardial Diseases Flashcards
what are the main pathologic features of hypertrophic cardiomyopathy?
concentric or asymmetric left ventricular hypertrophy
left atrial enlargement
right heart enlargement
what is compromised in hypertrophic cardiomyopathy?
diastolic filling
what does reduced left ventricular compliance lead to?
left atrial enlargement
how common is canine hypertrophic cardiomyopathy?
very uncommon
what is the most common cardiovascular disease in cats?
feline hypertrophic cardiomyopathy
what can feline hypertrophic cardiomyopathy cause?
CHF
arterial thromboembolism
syncope
sudden death
unexpected anesthesia death
what are some differential diagnoses for feline hypertrophic cardiomyopathy?
hypertrophic cardiomyopathy
systemic hypertension
congenital aortic stenosis
hyperthyroidism
other feline myocardial disease
what are some differential diagnoses for cardiac murmurs in cats?
cardiomyopathy
dynamic right ventricular outflow tract obstruction
systemic hypertension
hyperthyroidism
anemia
congenital heart disease
what can be heart of ausculation in feline hypertrophic cardiomyopathy?
cardiac murmur: sternal borders
cardiac gallop (S4): try bell of stethoscope
arrhythmia
what is hypertension?
get 3 measurements, 3 sessions
consistently above 160-170 mmHg
what is hypotension?
<90mmHg systolic
what heart laboratory tests can be done in feline hypertrophic cardiomyopathy?
NT-proBNP
cardiac troponin I
what level of NT-proBNP makes heart failure likely?
> 265 pmol/L
what drugs are used in hypertrophic cardiomyopathy?
beta blockers
calcium channel blockers
myosin inhibitors: possible future drugs
how many cats with cardiomyopathy get arterial thromboembolism?
10-40%
where do arterial thromboembolisms usually originate?
left atrium or ventricle
rarely right heart (PTE)
what percentage of arterial thromboembolisms go to the rear limbs?
85-90%
what can be used for prevention of arterial thromboembolism?
aspirin
low molecular weight heparin
clopidogrel
rivaroxaban or apixaban
coumadin (warfarin)
how is CHF managed in cats?
furosemide
pimobendan
ACE inhibitor
antithrombotics?
spironolactone
diet
what can canine hypertrophic cardiomyopathy result in?
sudden death
exercise intolerance
CHF
what is the main echo finding in canine hypertrophic cardiomyopathy?
concentric LV hypertrophy
what cats get feline hypertrophic cardiomyopathy?
any breed
any age
male>female
do cats with hypertrophic cardiomyopathy usually have a cough?
no
what can you look at in M mode echo for feline hypertrophic cardiomyopathy?
left ventricular free wall or interventricular septum
>0.55-0.6 cm in diastole
>0.9 cm in systole
what value of NT-proBNP is consistent with feline heart disease?
> 50-100 pmol/L
what are some beta blockers you can use in cats?
atenolol
carvedilol
what are some calcium channel blockers you can use in cats?
diltiazem
cardizem CD
dilacor
when can you use pimobendan in a cat?
with CHF if not left ventricular outflow tract obstruction
what can be used to treat arterial thromboembolism?
supportive care
antithrombotics
thrombolytics
surgical or catheter thrombolectomy
