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Dilated Cardiomyopathy (view source)
Revision as of 12:12, 5 September 2008
, 12:12, 5 September 2008New page: {{toplink |backcolour = |linkpage =Cardiology - WikiClinical |linktext =Cardiology |sublink1=Cardiovascular Conditions - WikiClinical |subtext1=CARDIOVASCULAR CONDITIONS |maplink1= Cardiov...
{{toplink
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
''a.k.a. Congestive Cardiomyopathy''
*Common in dogs
*Rare in cats (with adequate taurine supplementation)
===Signalment===
'''Dog:''' Giant and Large Breeds (e.g. Dobermann pinscher, Boxer, Cocker spaniel); Male>Female; Risk increases with age
'''Cat:''' Greatest risk in: Siamese, Burmese, Abyssinian; Male>Female; Middle Age & Old Age
===Description===
*Dilated cardiomyopathy (DCM) occurs when there is a progressive reduction in systolic myocardial contractility. Decreased myocardial contractility affects the removal of blood from the ventricle at systole. A larger volume of blood increases the end diastolic pressures causing dilation of the ventricle and the development of eccentric hypertrophy.
===Diagnosis===
====History & Clinical Signs====
-Asymptomatic (Occult) DCM: See in predisposed breeds (e.g. Doberman pinschers)
-'''Right-Sided Congestive Heart Failure Signs'''
*Giant Breeds usually prone to these
-'''Left-Sided Congestive Heart Failure Signs'''
*Boxers and Doberman pinschers have a higher risk
-Syncope
-Weight Loss
-Dyspnoea
-Lethargy
-Weakness
-Hindlimb Paresis (cats with saddle thrombi)
====Physical Exam====
-Systolic Murmur
-Gallop Rhythm
-S3 Heart Sound (+/-)
-Arrhythmias
-Pulse Deficits
-Pulmonary crackles
====Laboratory Findings====
-Azotemia
-Elevated Liver Enzymes (+ Liver Congestion)
-Signs of congestive heart failure
-Signs of thromboembolism (cats)
-Plasma taurine reduction (cats)
====Radiography====
-Left Ventricular Hypertrophy (Seen in Dobermans & Boxers)
-Left Atrial Enlargement (Seen in Dobermans & Boxers)
-Generalized Cardiomegaly (Seen in Giant Breeds)
-Left-Sided Congestive Heart Failure signs (pulmonary congestion & edema)
-Right-Sided Congestive Heart Failure signs (pleural effusion, ascites)
====Electrocardiography (ECG)====
-Rhythm Disturbances (e.g. Atrial fibrillation (Giant Breeds); Ventricular Arrhythmias (Doberman pinchers, Boxers))
-Conduction Disturbances
-Characteristic signs of hypertrophy
====Echocardiography====
-Hypokinetic left ventricle (i.e. reduced fractional shortening therefore reduced contractility)
-Reduced ejection fraction (i.e. % end diastolic volume ejected at systole)
-Decreased ventricular wall thickness
-Left atrial enlargement
-Mitral regurgitation
===Treatment===
-Treat congestive heart failure (Reduce Preload & Afterload; Improve Systolic Function; Control Cardiac Arrhythmias)
-Therapeutic thoracocentesis (To remove pleural effusion) (cats)
-Taurine Supplementation (cats)
===Prognosis===
'''Dogs'''
-Poor: Most breeds survive 6-12 months
-Grave: Dobermans and Boxers
'''Cats'''
-Good: When cardiomyopathy results from taurine deficiency
-Grave: Other causes of cardiomyopathy
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
''a.k.a. Congestive Cardiomyopathy''
*Common in dogs
*Rare in cats (with adequate taurine supplementation)
===Signalment===
'''Dog:''' Giant and Large Breeds (e.g. Dobermann pinscher, Boxer, Cocker spaniel); Male>Female; Risk increases with age
'''Cat:''' Greatest risk in: Siamese, Burmese, Abyssinian; Male>Female; Middle Age & Old Age
===Description===
*Dilated cardiomyopathy (DCM) occurs when there is a progressive reduction in systolic myocardial contractility. Decreased myocardial contractility affects the removal of blood from the ventricle at systole. A larger volume of blood increases the end diastolic pressures causing dilation of the ventricle and the development of eccentric hypertrophy.
===Diagnosis===
====History & Clinical Signs====
-Asymptomatic (Occult) DCM: See in predisposed breeds (e.g. Doberman pinschers)
-'''Right-Sided Congestive Heart Failure Signs'''
*Giant Breeds usually prone to these
-'''Left-Sided Congestive Heart Failure Signs'''
*Boxers and Doberman pinschers have a higher risk
-Syncope
-Weight Loss
-Dyspnoea
-Lethargy
-Weakness
-Hindlimb Paresis (cats with saddle thrombi)
====Physical Exam====
-Systolic Murmur
-Gallop Rhythm
-S3 Heart Sound (+/-)
-Arrhythmias
-Pulse Deficits
-Pulmonary crackles
====Laboratory Findings====
-Azotemia
-Elevated Liver Enzymes (+ Liver Congestion)
-Signs of congestive heart failure
-Signs of thromboembolism (cats)
-Plasma taurine reduction (cats)
====Radiography====
-Left Ventricular Hypertrophy (Seen in Dobermans & Boxers)
-Left Atrial Enlargement (Seen in Dobermans & Boxers)
-Generalized Cardiomegaly (Seen in Giant Breeds)
-Left-Sided Congestive Heart Failure signs (pulmonary congestion & edema)
-Right-Sided Congestive Heart Failure signs (pleural effusion, ascites)
====Electrocardiography (ECG)====
-Rhythm Disturbances (e.g. Atrial fibrillation (Giant Breeds); Ventricular Arrhythmias (Doberman pinchers, Boxers))
-Conduction Disturbances
-Characteristic signs of hypertrophy
====Echocardiography====
-Hypokinetic left ventricle (i.e. reduced fractional shortening therefore reduced contractility)
-Reduced ejection fraction (i.e. % end diastolic volume ejected at systole)
-Decreased ventricular wall thickness
-Left atrial enlargement
-Mitral regurgitation
===Treatment===
-Treat congestive heart failure (Reduce Preload & Afterload; Improve Systolic Function; Control Cardiac Arrhythmias)
-Therapeutic thoracocentesis (To remove pleural effusion) (cats)
-Taurine Supplementation (cats)
===Prognosis===
'''Dogs'''
-Poor: Most breeds survive 6-12 months
-Grave: Dobermans and Boxers
'''Cats'''
-Good: When cardiomyopathy results from taurine deficiency
-Grave: Other causes of cardiomyopathy