Acquired Valvular Heart Disease Student Notes PDF
Document Details
Uploaded by OticMilkyWay4641
Hillary Hammond
Tags
Summary
These student notes provide a comprehensive overview of acquired valvular heart disease, encompassing learning objectives, pathophysiology, clinical features, and diagnostics. The document is geared toward veterinary or animal health students, addressing various aspects of the condition in different animal species. The document also includes images.
Full Transcript
ACQUIRED VALVULAR HEART DISEASE Hillary Hammond, DVM, MS, DACVIM (Cardiology) LEARNING OBJEC TIVES Be able to describe the following for acquired valvular disease: What valves are usually affected in various species? Pathophysiology of the disease and how...
ACQUIRED VALVULAR HEART DISEASE Hillary Hammond, DVM, MS, DACVIM (Cardiology) LEARNING OBJEC TIVES Be able to describe the following for acquired valvular disease: What valves are usually affected in various species? Pathophysiology of the disease and how it leads to heart failure Appropriate diagnostic testing ACVIM Classification stages for dogs and what treatment is warranted at each stage Understand the clinical signs and physical examination findings can be seen in patients with acquired valve disease, with and without congestive heart failure (CHF) Understand appropriate therapies for CHF secondary to acquired valve disease What is acquired valvular disease? Clinical Features Pathophysiology Physical Exam Findings OU TLINE Diagnostics Echocardiography Radiographs Electrocardiography Other Management/Staging ETYMOLOGY Acquired valvular heart disease Myxomatous valve disease (MVD) Degenerative valve disease (DVD) Chronic degenerative valve disease Endocardiosis NORMAL VALVE Atrialis: elastic and collagen fibers Spongiosa: extracellular matrix (ECM) rich in proteoglycans and occasional interstitial cells Fibrosa: tightly packed collagen fibers MYXOMATOUS VALVE Non-inflammatory progressive disarray of the valve structure: Interstitial cells are activated Excessive deposition of ECM Fragmentation and disorganizing of elastic and collage fibers Damage to endothelial cell lining DOGS CLINIC AL FEATURES Most common cause of heart disease in dogs (>70%) More common in small to medium breed dogs (Tricuspid Risk factors: male sex and increasing age Typically >10 years of age NORMAL AORTIC VALVE Separates LV and Aorta Closed diastole, open systole Apparatus consists of: Three cusps: left coronary, right coronary, noncoronary Annulus Valve leaflets should be thin, translucent, and smooth DEGENERATIVE AORTIC VALVE Progressive disarray of valve structure → Thickened, nodular leaflets Normal Myxomatous PATHOPHYSIOLOGY Degeneration Aortic Regurgitation LV volume overload LV eccentric hypertrophy LA dilation Mitral annular dilatation Mitral regurgitation Myxomatous Degeneration PATHOPHYSIOLOGY Aortic Regurgitation LV volume overload LV eccentric hypertrophy LA dilation Mitral annular dilatation Mitral regurgitation Increase in LA pressure and LV wall stress Increase in pulmonary venous and capillary hydrostatic pressure Left sided CHF +/- secondary pulmonary hypertension PHYSIC AL EXAM - MURMUR Grade/ Intensity: typically increases with progression of disease PMI: cardiac base, left (over aorta) Timing: diastolic Insufficiency/regurgitation through aortic valve (when supposed to be closed) CLINIC AL OUTCOMES None Severe May be asymptomatic Reduced exercise capacity Colic-like signs Heart rhythm disturbances Congestive heart failure (CHF) Sudden cardiac death DIAGNOSTICS Echocardiogram: Thickened and irregular aortic valve leaflets Diastolic aortic insufficiency +/- LA and LV enlargement DIAGNOSTICS Electrocardiogram (ECG) Evaluate for arrhythmias Exercise ECG testing OTHER SPECIES? QUESTIONS? [email protected]
