Test 1: lecture 9 mitral valve Flashcards

1
Q

cavilers have what heart issue

A

mitral valve disease

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2
Q

mitral valve disease makes up —% of canine cardiac disease

A

75-80%

more common in small dogs

Cavalier King Charles Spaniel

no sex predilection

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3
Q

the chordea tendinea are made of

A

fibrosa layer of mitral valve

dense collagen fibers

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4
Q

layers of the mitral valve

A
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5
Q

what happens to valve with myxomatous mitral valve

A

fibrosa layer becomes smaller/degrades

spongiosa layer thickens

endothelial layer forms nodules

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6
Q

most dogs with mild MVD will —

A

never have clinical signs

not have CHF (they will be fine)

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7
Q
A

mitral valve disease

nodular valve
jet lesion in atria
ruptured chordea tendinea

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8
Q

what cell causes damage to mitral valve

A

valvular interstitial cell

will get turned on and degrade fibrosa layer and cause nodules in endothelial layer

activated by stress, age and injury

convert to myofibroblast phenotype (remodel ECM to MVD)

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9
Q

how does MVD effect kidney

A

lower stroke volume= lower renal perfusion

kidney will increase RAAS and cause increased LV volume

this leads to LV eccentric hypertrophy (thin walls big volume)

which leads to increased pulmonary venous pressure and CHF

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10
Q

what causes MVD

A

we dont really know

BUT NOT INFECTIOUS

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11
Q

what kind of murmur will MVD cause

A

left sided systolic apical

can be soft- thrilling

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12
Q

false positive murmur

A

loud murmur but mild disease

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13
Q

false negative murmur

A

soft murmur with severe disease

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14
Q

how to predict how bad MVD is

A

clinical signs: exercise intolerance, fainting, dyspnea

EKG: errhythmias

XRays- large heart= bad, CHF or pulomonary venous distension

Echo: volume overload, thickened and prolapse valve

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15
Q

EKG changed for mitral valve disease

A

wide P wave: Left atrial enlargment
Tall R waves: LV enlargment
wide QRS: LV enlargment

APC or VPCs can occur
Afib can happen with severe atrial enlargement

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16
Q

xray of dogs with MVD will show

A

big heart

LA,LV enlargement
pulmonary venous distension
perihilar interstital/alveolar (CHF/edema)

17
Q

echo of MVD will show

A

thickened valve leaflets
prolapse
ruptured chordae tenineae

regurg into the left atrium (jet lesion)

18
Q

4 stages of MVD

A

A: no disease, but at risk
B: MVD but no clinical signs
B1: no heart enlargement
B2: heart enlargement
C: MVD, CHF and on meds
D: MVD advanced disease, refractory clinical signs

19
Q

Stage A MVD

A

no disease but at risk based on breed

20
Q

Stage B MVD

A

MVD present, but no clinical signs

21
Q

Stage B1 MVD

A

MVD with no clinical signs and no cardiac enlargement

22
Q

Stage B2 MVD

A

MVD with no clinical signs but + cardiac enlargement

23
Q

Stage C MVD

A

MVD present, CHF, on meds

24
Q

Stage D MVD

A

MVD present, advanced disease, refractory clinical signs

25
Q

how to treat stage B2 MVD

A

pimobendan
(ACEI)

can slow down disease, keeps them asymptomatic longer

26
Q

differential for MVD: cough and murmur

A

primary respiratory disease: COPD, Asthma, allergic bronchitis, collapsing trachea

Xray will have NO heart enlargment

27
Q

how to treat acute CHF therapy for MVD

A

FOND

furosemide (preload)
oxygen
nitro (pre/afterload)
dobutamine (inotropy)

28
Q

how to treat chronic CHF therapy for MVD

A

FASP

furosemide (preload)
ACT inhibitor (decreases RAAS)
pimobendan
spironolactone

29
Q

enalapril will do — with MVD

A

will not delay onset of heart failure in stage B MVD

30
Q

primobendan given to stage B2 MVD will do

A

give 15 extra months with no CHF symptoms

31
Q

MVD complications

A

left atrial tear from jet lesion (leads to pericardial effusion)

ruptured chordae tendinae

arrhythmias (Afib, APC, VPC)

32
Q
A