Hypertrophic Cardiomyopathy and Other Feline Myocardial Diseases Flashcards

1
Q

what are the main pathologic features of hypertrophic cardiomyopathy?

A

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

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2
Q

what is compromised in hypertrophic cardiomyopathy?

A

diastolic filling

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3
Q

what does reduced left ventricular compliance lead to?

A

left atrial enlargement

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4
Q

how common is canine hypertrophic cardiomyopathy?

A

very uncommon

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5
Q

what is the most common cardiovascular disease in cats?

A

feline hypertrophic cardiomyopathy

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6
Q

what can feline hypertrophic cardiomyopathy cause?

A

CHF
arterial thromboembolism
syncope
sudden death
unexpected anesthesia death

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7
Q

what are some differential diagnoses for feline hypertrophic cardiomyopathy?

A

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

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8
Q

what are some differential diagnoses for cardiac murmurs in cats?

A

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

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9
Q

what can be heart of ausculation in feline hypertrophic cardiomyopathy?

A

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

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10
Q

what is hypertension?

A

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

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11
Q

what is hypotension?

A

<90mmHg systolic

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12
Q

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

A

NT-proBNP
cardiac troponin I

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13
Q

what level of NT-proBNP makes heart failure likely?

A

> 265 pmol/L

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14
Q

what drugs are used in hypertrophic cardiomyopathy?

A

beta blockers
calcium channel blockers
myosin inhibitors: possible future drugs

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15
Q

how many cats with cardiomyopathy get arterial thromboembolism?

A

10-40%

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16
Q

where do arterial thromboembolisms usually originate?

A

left atrium or ventricle
rarely right heart (PTE)

17
Q

what percentage of arterial thromboembolisms go to the rear limbs?

A

85-90%

18
Q

what can be used for prevention of arterial thromboembolism?

A

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

19
Q

how is CHF managed in cats?

A

furosemide
pimobendan
ACE inhibitor
antithrombotics?
spironolactone
diet

20
Q

what can canine hypertrophic cardiomyopathy result in?

A

sudden death
exercise intolerance
CHF

21
Q

what is the main echo finding in canine hypertrophic cardiomyopathy?

A

concentric LV hypertrophy

22
Q

what cats get feline hypertrophic cardiomyopathy?

A

any breed
any age
male>female

23
Q

do cats with hypertrophic cardiomyopathy usually have a cough?

A

no

24
Q

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

A

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

25
Q

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

A

> 50-100 pmol/L

26
Q

what are some beta blockers you can use in cats?

A

atenolol
carvedilol

27
Q

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

A

diltiazem
cardizem CD
dilacor

28
Q

when can you use pimobendan in a cat?

A

with CHF if not left ventricular outflow tract obstruction

29
Q

what can be used to treat arterial thromboembolism?

A

supportive care
antithrombotics
thrombolytics
surgical or catheter thrombolectomy