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2- SA- Cardiology > Myocardial disease in small animals > Flashcards

Myocardial disease in small animals Flashcards

1
Q

what is myocardial disease

A

weakness or thickening of the heart muscle

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2
Q

What are the four types of primary myocardial diseases

A

dilated cardiomyopathy (DCM)
Arrhythmogenic right ventricular cardiomyopathy (ARVC)-
Hypertrophic cardiomyopathy (most common in cats)
Restrictive cardiomyopathy (common in cats

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3
Q

List 3 secondary causes of myocardial disease

A

Infective myocarditis
deficiency diseases
toxic causes

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4
Q

Describe dilated cardiomyopathy (DCM)

A

characteristics by impaired myocardial contractility
left ventricle becomes weakened and enlarged, and is unable to pump blood efficiently throughout the body
DCM is an end stage of many cardiac diseases

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5
Q

What is the most common type of myocardial disease in dogs

A

dilated cardiomyopathy

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6
Q

What is the predisposition for dilated cardiomyopathy

A

BIG DOGS
doberman, newfoundland, IWH, st Bernards, Labradors, Great Dane, GSD
Cocker spaniels
Usually dogs over 12kg
usually middle aged dogs

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7
Q

What are the clinical signs of dilated cardiomyopathy

A

Occult phase- non-symptomatic - can last weeks- years
symptomatic phase= syncope, weight loss, sudden death, soft murmur, atrial fibrillation, if right side affected will see ascities

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8
Q

what is atrial fibrillation

A

quivering or irregular heartbeat, usually rapid

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9
Q

what is the common history of a dog with DCM

A

exercise intolerance
recent weight loss
inappetence/ anorexia
cough

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10
Q

What will you observe on a clinical exam of a dog with dilated cardiomyopathy?

A

Tachycardia +/- arrythmias (atrial fibrillation, Ventricular premature complexes, Ventricular tachycardia)
Pulse defecits
LCHF
Galloping sounds
Soft murmurs

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11
Q

What will you see on a clinical exam of a dog with DCM if there is forward failure?

A

Pale mucous membranes
sluggish CRT
cold extremities
THIS IS A BAD SIGNS

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12
Q

How would you diagnose DCM

A

Echocardiograph (often definitive diagnosis) + doppler
Electrocardiograph
Radiography- confirms CHF
24hr Holter monitor- more for screening

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13
Q

What will you see on an echocardiography of a dog with DCM?

A

Left atrial and left ventricle enlargement with normal or occasionally thinly-walled dilated ventricles.

Rounded apex - reduced index of sphericity.

Hypokinetic (Large, round, poorly contractile) left ventricle.

Massive left atrial dilatation is often seen in Irish Wolfhound.

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14
Q

What will you see in an M-mode echocardiography of a dog with DCM

A

increased E point to septal separation if left dilation

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15
Q

What do you tend to see on a radiograph of a dog with DCM

A

gross generalised cardiomegaly
left atrial and ventricular enlargement
pulmonary venous congestion and pulmonary oedema
pleural effusion

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16
Q

What do you tend to see on ECG of a dog with DCM

A

Findings are very variable from normal to wide +/- tall complexes (occasionally small complexes).

*Many dogs will present with atrial fibrillation
*If in CHF the ventricular rate maybe very rapid
* Rate control is the key

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17
Q

Why would you use a holter monitor in patients with cardiomyopathies?

A
  1. To monitor for heart rate control
  2. Unexplained syncope or collapse
  3. Arrhythmias
    4 .Monitoring therapy
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18
Q

How would you treat dilated cardiomyopathy

A

Diuretics
ACE inhibitors
Beta blockers (carvedilol, metoprolol, bisoprolol)
Inotropes (pimobendan)- to improve contractility

Limit salt and fluid intake

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19
Q

What is arrhythmogenic right ventricular cardiomyopathy (ARVC)?

A

A disease in which the heart muscles atrophy and are replaced by fibrous, fatty tissue.
rhythm disturbance caused by the cardiac muscle in the right ventricle

Commonly affects boxers

20
Q

What are the three stages of arrythmic right ventricular cardiomyopathy (ARVC)?

A

1 - Asymptomatic with ventricular arrhythmias
2 - Symptomatic with normal heart size and LV function but the dogs are syncope / weak from ventricular arrythmias.
3 - Congestive heart failure: poor myocardial function and ventricular arrhythmias

21
Q

What are the clinical signs of Arrythmic Right Ventricular Cardiomyopathy

A

Supra-ventricular arrhythmias
Ventricular arrythmias
Syncope
Death

22
Q

How would you investigate a suspected ARVC?

A

ARVC is a diagnosis of exclusion:

Holter monitor is necessary.

The identification of a severe arrhythmia in the absence of other underlying disease, especially in the presence of clinical signs (Type II dogs) can make for a straightforward diagnosis.

23
Q

How would you treat ARVC

A

treat any heart failure
anti-arrhythmic medication–> soltalol (beta blocker- commonly used)

24
Q

What is the most common myocardial disease of cats

A

hypertrophic cardiomyopathy (HCM)

25
Q

What is hypertrophic cardiomyopathy

A

Inappropriate myocardial hypertrophy of a non-dilated left ventricle, occurring in the absence of an identifiable stimulus

26
Q

how do you diagnose hypertrophic cardiomyopathy

A

is a diagnosis of exclusion- need to make sure there isn’t another cause e.g. hyperthyroidism

27
Q

what are the 2 clinical forms of hypertrophic cardiomyopathy

A

obstructive and non-obstructive
treated in the same way

28
Q

what is the signalment of hypertrophic cardiomyopathy

A

maine coons
ragdolls
rare in dogs

29
Q

what is restrictive cardiomyopathy

A

build up of fibrosis in the ventricles
atrial enlargement due to poor ventricular filling and regurgitation

30
Q

how do cats with cats with cardiomyopathies generally present

A

often present in heart failure
Range from asymptomatic cat with a heart murmur (are rare in cats) to recumbent, cold dyspnoeic cat via congestive cardiac failure

31
Q

what generally causes feline dilated cardiomyopathy

A

taurine deficiency
taurine levels in commercial diets has been increased so rarer now

32
Q

what must you not give a hypertrophic cardiomyopathy cat

A

pimobendan- as increases the contractility - making the already thickened heart work even harder

33
Q

which side is affected in DCM

A

left usually but can also be the right

34
Q

what are the 2 main types of DCM

A

narrow myocardial cells
OR
myofibre degeneration

35
Q

what are the 2 phases of DCM

A

occult phase and symptomatic phase

36
Q

what type of arrythmias do many DCM dogs have

A

ventricular arrythmias

37
Q

what is a holter monitor

A

a portable electrocardiograph that is worn by an ambulatory patient to continuously monitor the heart rates and rhythms over a 24-hour period

38
Q

how can doxorubicin affect the heart

A

it can lead to cardiotoxicity

39
Q

name two nutrients that can lead to secondary myocardial disease if deficient

A

L-carnitine
taurine

40
Q

List 5 types of myocardial disease in cats

A

hypertrophic cardiomyopathy
restrictive cardiomyopathy
dilated cardiomyopathy
arrythmogenic right ventricular cardiomyopathy
feline unclassified cardiomyopathy

41
Q

what are 4 things that can lead to concentric hypertophy (not HCM)

A

aortic stenosis
systemic hypertension
metabolic disorders
renal disease and associated hypertension

42
Q

Describe obstructive HCM

A

blood can’t get out of the aorta due to a thickened septum, mitral valve has flopped into the aorta due to pressure and this has become obstructive

43
Q

what happens to the atria in HCM

A

They enlarge due to the inability to move all the blood into the ventricles

44
Q

what is the difference between HCM and RCM

A

in HCM, the walls are thickened. In RCM, the walls are normal size but the constriction is bad

45
Q

what are the 2 forms of RCM

A

endomyocardial and myocardial

46
Q

what can be seen on radiography of a feline HCM

A

pleural effusion
pulmonary oedema
cardiomegaly and venous congestion

47
Q

can dogs get HCM

A

yes but it is rare

2- SA- Cardiology (15 decks)

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