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Degenerative Mitral Valve Disease (view source)
Revision as of 13:31, 5 September 2008
, 13:31, 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>
[[Image:AV valve dysplasia cat.jpg|right|thumb|125px|<small><center>'''Mitral dyplasia'''. Courtesy of A. Jefferies</center></small>]]
*Common in dogs and cats
*Rare in other species
===Signalment===
Genetics & Predisposed Breeds: Large Breeds (e.g., Bull Terrier, Miniature Bull Terrier, English Bulldog, Great Dane, German Shepherd, Newfoundland, Irish Setter)
===Description===
*Congenital malformation of the mitral valve and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets, annulus) results in mitral stenosis (narrowing) or regurgitation (insufficiency)
*Mitral Stenosis: left ventricle is not able to fill completely during diastole; Increase in left atrial pressures
*Mitral Regurgitation (Insufficiency): leaky mitral valve allows blood to flow back into atria causing increased left atrial pressure and increased pressure in the pulmonary veins
===Diagnosis===
====History & Clinical Signs====
Mild defects may be asymptomatic
Signs of left sided congestive (dilated) heart failure:
-Cough
-Tachypnea/Dyspnea
-Exercise Intolerance
-Syncope
-Pale Mucous Membranes
-Tachycardia
-Arrhythmias
====Physical Exam====
-Left apical systolic murmur
-Left diastolic murmur
-Poor pulses
====Radiographic Findings====
-Left atrial enlargement
-Left ventricular enlargement
-Enlargement of pulmonary veins
-Pulmonary edema
====Echocardiographic Findings====
-Left atrial enlargement
-Left ventricular enlargement
-Malformed valve leaflets
Doppler can detect mitral stenosis or regurgitation and estimate pressures in the left atrium and pulmonary veins
====Electrocardiographic (ECG)====
-May be normal
-Signs of left atrial (wide P waves)
-Signs of left ventricular (tall R waves)
-Signs of arrhythmias
===Treatment===
Control left atrial pressure and manage left sided congestive heart failure
'''Goal of treatment for congestive heart failure:'''
-Diuretics (decrease venous congestion)
-ACE-inhibitors; Vasodilators (inhibit water retention and dilate the vessels)
-Anti-coagulants (cats) to prevent thrombus formation
===Prognosis===
'''Mild Defects'''
-Excellent
'''Severe Defects'''
-Guarded
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
[[Image:AV valve dysplasia cat.jpg|right|thumb|125px|<small><center>'''Mitral dyplasia'''. Courtesy of A. Jefferies</center></small>]]
*Common in dogs and cats
*Rare in other species
===Signalment===
Genetics & Predisposed Breeds: Large Breeds (e.g., Bull Terrier, Miniature Bull Terrier, English Bulldog, Great Dane, German Shepherd, Newfoundland, Irish Setter)
===Description===
*Congenital malformation of the mitral valve and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets, annulus) results in mitral stenosis (narrowing) or regurgitation (insufficiency)
*Mitral Stenosis: left ventricle is not able to fill completely during diastole; Increase in left atrial pressures
*Mitral Regurgitation (Insufficiency): leaky mitral valve allows blood to flow back into atria causing increased left atrial pressure and increased pressure in the pulmonary veins
===Diagnosis===
====History & Clinical Signs====
Mild defects may be asymptomatic
Signs of left sided congestive (dilated) heart failure:
-Cough
-Tachypnea/Dyspnea
-Exercise Intolerance
-Syncope
-Pale Mucous Membranes
-Tachycardia
-Arrhythmias
====Physical Exam====
-Left apical systolic murmur
-Left diastolic murmur
-Poor pulses
====Radiographic Findings====
-Left atrial enlargement
-Left ventricular enlargement
-Enlargement of pulmonary veins
-Pulmonary edema
====Echocardiographic Findings====
-Left atrial enlargement
-Left ventricular enlargement
-Malformed valve leaflets
Doppler can detect mitral stenosis or regurgitation and estimate pressures in the left atrium and pulmonary veins
====Electrocardiographic (ECG)====
-May be normal
-Signs of left atrial (wide P waves)
-Signs of left ventricular (tall R waves)
-Signs of arrhythmias
===Treatment===
Control left atrial pressure and manage left sided congestive heart failure
'''Goal of treatment for congestive heart failure:'''
-Diuretics (decrease venous congestion)
-ACE-inhibitors; Vasodilators (inhibit water retention and dilate the vessels)
-Anti-coagulants (cats) to prevent thrombus formation
===Prognosis===
'''Mild Defects'''
-Excellent
'''Severe Defects'''
-Guarded