Valvular disease

Question 1

What is the most common cardiac disease?

Answer 1

Myxomatous degenerative valve disease (MDVD)

Question 2

MDVD has a slow progression over the years. What causes nodular thickening of the valve leaflets?

Answer 2

Glycosaminoglycan (GAG) and proteoglycan accumulation

Question 3

What is the staging for MDVD?

Answer 3

A - at risk
B1 - murmur, no enlargement
B2 - mumur, enlargement
C1 - CHF (hospitalised)
C2 - CHF (home)
D1 - refractory (hospitalised)
D2 - refractory (home)

Question 4

Small breeds and CKCS are most commonly affected by MDVD but all breeds can be affected. What large breeds are predisposed to MDVD?

Answer 4

GSD

Labrador

Question 5

What heart murmur is seen with MDVD?

Answer 5

Left sided apical systolic murmur

Question 6

What biomarker can be used to assess the severity of heart disease/failure?

Answer 6

NTPro-BNP

Question 7

What common arrhythmias may be seen with MDVD?

Answer 7

Supra/ventricular premature complexes

Atrial fibrillation

Question 8

What treatment is needed for each stage of MDVD?

Answer 8

A and B1 - no treatment
B2 - pimobendan (licensed for preclinical MDVD)
C - standard CHF therapy (FPAS)
D - higher doses and adding in sequential nephron blockade

Question 9

Do CKCS have a better or worse prognosis than other breeds for MDVD?

Answer 9

Better - earlier onset

Question 10

Endocarditis causes vegetations of the endocardial surface of valve leaflets. How is endocarditis diagnosed?

Answer 10

Blood culture - prior to ABs, often false negatives

ECG - valvular vegetations