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Degenerative Mitral Valve Disease (view source)
Revision as of 23:16, 15 November 2010
, 23:16, 15 November 2010no edit summary
*Exercise Intolerance
*Exercise Intolerance
*Cough
*Cough
* Dyspnoea
*Dyspnoea
*Sudden death due to left atrial tear and pulmonary oedema
*Sudden death due to left atrial tear and pulmonary oedema
===Clinical Signs===
===Clinical Signs===
*Cardiomegaly with dorsal displacement of the trachea
*Cardiomegaly with dorsal displacement of the trachea
*Pulmonary Venous Congestion (Enlarged pulmonary Arteries and Veins)
*Pulmonary Venous Congestion (Enlarged pulmonary Arteries and Veins)
* Pulmonary Oedema
*Pulmonary Oedema
Evidence of Right sided congestive heart failure maybe evident in severe cases e.g. distended caudal vena cava, hepatomegaly, ascites, pleural effusions.
Evidence of Right sided congestive heart failure maybe evident in severe cases e.g. distended caudal vena cava, hepatomegaly, ascites, pleural effusions.
===Electrocardiogram (ECG)===
===Electrocardiogram (ECG)===
* Enlarged Left Atrium (Wide P Wave)
*Enlarged Left Atrium (Wide P Wave)
*Enlarged Left Ventricle (Tall R wave, wide QRS complex, shift of mean electrical axis to the left)
*Enlarged Left Ventricle (Tall R wave, wide QRS complex, shift of mean electrical axis to the left)
*Rhythm disturbances - Sinus Tacchycardia, Atrial Fibrillation, Atrial premature complexes,Atrial Tacchycardia.
*Rhythm disturbances - Sinus Tacchycardia, Atrial Fibrillation, Atrial premature complexes,Atrial Tacchycardia.
==Treatment==
==Treatment==
No treatment is recommended prior to the onset of heart failure. Treatment is aimed at managing congestive heart failure through a combination of drugs.
No treatment is recommended prior to the onset of heart failure. Once there is evidence of congestive heart failure, treatment is aimed at its management through a combination of drugs.
The aims of treatment are to:
The aims of treatment are to:
1. '''Reduce Preload'''
::Diuretics to reduce circulating fluid volume (Frusemide, Benzofluazide, Spironolactone, Amiloride)
::Vasodilators to reduce venous return (Nitrates, ACE inhibitors, Alpha antagonists)
2. '''Reduce Afterload
::Vasodilators to decrease systemic vascular resistance
:::ACE inhibitors e.g. Enalapril, Benzapril, Imidopril ,
:::Pimobendan
:::Calcium channel blockers e.g. Amlodipine
:::Nitrates e.g. Nitropusside
3. '''Enhance Systolic function
::Positive Inotropes to increase cardiac contractility and increase cardiac output.
:::Pimobendan
:::Digoxin
:::Dobutamine
:::Xanthines
4. '''Improve Diastolic function
::Negative Chronotropes to increase the length of diastole (digoxin, atenolol)
::Calcium channel blockers to improve relaxation (amlodipine)
5. '''Control cardiac arrhythmias using anti-arrhythmic drugs
==Prognosis==
==Prognosis==