Term
|
Definition
|
|
Term
| What are the clinical signs of vavlular degen? |
|
Definition
-asymptomatic
-resp distress
-cough
-syncope
-exercise intolerance |
|
|
Term
| What are some of our initial diagnostics for a murmur? |
|
Definition
-HW test
-chest rads
-BP
-echo
-CBC/chem
-SPO2 % |
|
|
Term
| If animals are unstable and have a murmur, what do we do? |
|
Definition
| -symptomatic treatment first |
|
|
Term
| What is the purpose of an echo? |
|
Definition
-assess cause and severity of cardiac dz when murmur is present
-rule out cardaic dz
-assess degree of pulmonary hypertension |
|
|
Term
| When should echo be considered? |
|
Definition
-onset of new murmur
-sudden inc in intensity of murmur
-anesthesia
-CHF
-unexpected breed or age
-tx is not working well |
|
|
Term
| What is myxomatous mitral valve dz (endocardiosis)? |
|
Definition
-changes include expansion of extracellular matrix w/ glycosaminoglycans and ptoeoglycans
-valvular interstitial cll alteration
-attenuation or loss of collagen-laden fibrosa layer
-these lead to malformation of the mitral apparatus, biomechanical dysfunction, and mitral incompetence |
|
|
Term
| Does the mechanical dysfunction of the valve affect bloodflow? |
|
Definition
| -not really, it is the distortion of the valve that leads to leakage/regurgitation |
|
|
Term
| In general, how does mitral dz compare to tricuspid dz? |
|
Definition
-mitral often affected w/ a higher frequency and severity than the tircupsid
-HOWEVER, it is common to see mitral and tricuspid regurg together |
|
|
Term
| Describe the prevelance of valvular degen. |
|
Definition
| -every dog will get valve degen if they live long enough |
|
|
Term
| What is the typical age of onset of valve degen? Breed disposition? |
|
Definition
-6-9y
-Cavalier King Charles Spaniel |
|
|
Term
| What would be your first clue during PE that valve degen has started? |
|
Definition
-mid systolic click (valve prolapse and/or systolic murmur)
-may hear arrhythmias |
|
|
Term
| Can we cure valve degen (endocardiosis) w/ meds? |
|
Definition
| -no, can manage it but not a cure |
|
|
Term
| How does diet effect endocardiosis? |
|
Definition
-mod sodium restriction
-senior diet or other heart diets |
|
|
Term
| If we are giving Furosemide, what must we give concurrently? |
|
Definition
|
|
Term
| How does Enalapril affect the kidneys? |
|
Definition
| -is completely metabolized by the kidneys thus either dec dose w/ kidney problems or switch drugs |
|
|
Term
|
Definition
| -inodilator and inc sensitivity to Ca |
|
|
Term
| What are the MVD benefits of pimobendan? |
|
Definition
| -enhances annular and LV papillary tone, making any concurent reductions in afterload better toleratedd |
|
|
Term
| What is the combined mechanisms of pimobendan in the case of MVD? |
|
Definition
| -pharmacological annuloplasty |
|
|
Term
| What is our major concern w/ giving ace inh plus Pimobendan too early? |
|
Definition
|
|
Term
| What are some valve degen complications other than CHF? |
|
Definition
-arrhythmias
-pulmonary hypertension
-ruptured shordal structures
=left atrial tears |
|
|
Term
| Are atrial or ventricular arrhythmias more commonly seen w/ MVD? |
|
Definition
| -atrial due to left atrial dialtiation |
|
|
Term
| How do we treat atrial arrhythmias w/ MVD? |
|
Definition
-Digoxin if in CHF
=Diltiazem if not in CHF |
|
|
Term
| How do we treat pulmonary hypertenion? |
|
Definition
-treat underlying pulmonary dz or left-sided heart dz
-Sildenafil, L-arginine, and PImobendan |
|
|
Term
| HOw can you confirm chordal rupture on necropsy? |
|
Definition
| -fill heart back up w/ water and if valve dangles then real chordal rupture |
|
|
Term
| What is a left atrial tear? |
|
Definition
-a tearing in the jet lesions
-not good surgical candidates |
|
|
Term
| Is MVD with systolic dysfunction more likely to happen w/ small breed dog or large breed dog? |
|
Definition
-large
-add ace inh in asymptomatic patient |
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