Hypertrophic Cardiomyopathy and Other Feline Myocardial Diseases

Question 1

what are the main pathologic features of hypertrophic cardiomyopathy?

Answer 1

concentric or asymmetric left ventricular hypertrophy
left atrial enlargement
right heart enlargement

Question 2

what is compromised in hypertrophic cardiomyopathy?

Answer 2

diastolic filling

Question 3

what does reduced left ventricular compliance lead to?

Answer 3

left atrial enlargement

Question 4

how common is canine hypertrophic cardiomyopathy?

Answer 4

very uncommon

Question 5

what is the most common cardiovascular disease in cats?

Answer 5

feline hypertrophic cardiomyopathy

Question 6

what can feline hypertrophic cardiomyopathy cause?

Answer 6

CHF
arterial thromboembolism
syncope
sudden death
unexpected anesthesia death

Question 7

what are some differential diagnoses for feline hypertrophic cardiomyopathy?

Answer 7

hypertrophic cardiomyopathy
systemic hypertension
congenital aortic stenosis
hyperthyroidism
other feline myocardial disease

Question 8

what are some differential diagnoses for cardiac murmurs in cats?

Answer 8

cardiomyopathy
dynamic right ventricular outflow tract obstruction
systemic hypertension
hyperthyroidism
anemia
congenital heart disease

Question 9

what can be heart of ausculation in feline hypertrophic cardiomyopathy?

Answer 9

cardiac murmur: sternal borders
cardiac gallop (S4): try bell of stethoscope
arrhythmia

Question 10

what is hypertension?

Answer 10

get 3 measurements, 3 sessions
consistently above 160-170 mmHg

Question 11

what is hypotension?

Answer 11

<90mmHg systolic

Question 12

what heart laboratory tests can be done in feline hypertrophic cardiomyopathy?

Answer 12

NT-proBNP
cardiac troponin I

Question 13

what level of NT-proBNP makes heart failure likely?

Answer 13

> 265 pmol/L

Question 14

what drugs are used in hypertrophic cardiomyopathy?

Answer 14

beta blockers
calcium channel blockers
myosin inhibitors: possible future drugs

Question 15

how many cats with cardiomyopathy get arterial thromboembolism?

Answer 15

10-40%

Question 16

where do arterial thromboembolisms usually originate?

Answer 16

left atrium or ventricle
rarely right heart (PTE)

Question 17

what percentage of arterial thromboembolisms go to the rear limbs?

Answer 17

85-90%

Question 18

what can be used for prevention of arterial thromboembolism?

Answer 18

aspirin
low molecular weight heparin
clopidogrel
rivaroxaban or apixaban
coumadin (warfarin)

Question 19

how is CHF managed in cats?

Answer 19

furosemide
pimobendan
ACE inhibitor
antithrombotics?
spironolactone
diet

Question 20

what can canine hypertrophic cardiomyopathy result in?

Answer 20

sudden death
exercise intolerance
CHF

Question 21

what is the main echo finding in canine hypertrophic cardiomyopathy?

Answer 21

concentric LV hypertrophy

Question 22

what cats get feline hypertrophic cardiomyopathy?

Answer 22

any breed
any age
male>female

Question 23

do cats with hypertrophic cardiomyopathy usually have a cough?

Answer 23

no

Question 24

what can you look at in M mode echo for feline hypertrophic cardiomyopathy?

Answer 24

left ventricular free wall or interventricular septum
>0.55-0.6 cm in diastole
>0.9 cm in systole

Question 25

what value of NT-proBNP is consistent with feline heart disease?

Answer 25

>50-100 pmol/L

Question 26

what are some beta blockers you can use in cats?

Answer 26

atenolol carvedilol

Question 27

what are some calcium channel blockers you can use in cats?

Answer 27

diltiazem cardizem CD dilacor

Question 28

when can you use pimobendan in a cat?

Answer 28

with CHF if not left ventricular outflow tract obstruction

Question 29

what can be used to treat arterial thromboembolism?

Answer 29

supportive care antithrombotics thrombolytics surgical or catheter thrombolectomy