Difference between revisions of "Hypertrophic Cardiomyopathy"

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== Introduction  ==
|backcolour =
 
|linkpage =Cardiology - WikiClinical
 
|linktext =Cardiology
 
|sublink1=Cardiovascular Conditions - WikiClinical
 
|subtext1=CARDIOVASCULAR CONDITIONS
 
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
 
|pagetype=Clinical
 
}}
 
<br>
 
[[Image:hypertrophic cardiomyopathy.jpg|right|thumb|125px|<small><center>'''Hypertrophic cardiomyopathy (cat)'''. Courtesy of T. Scase</center></small>]]
 
[[Image:hypertrophic cardiomyopathy 2.jpg|right|thumb|125px|<small><center>'''Hypertrophic cardiomyopathy (cat)'''. Courtesy of T. Scase</center></small>]]
 
  
*Rare in dogs
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Left ventricular '''concentric hypertrophy''' without an identifiable cause is known as hypertrophic cardiomyopathy. The ventricular myocardium becomes so thick that the lumen is reduced to a size that is not compatible with maintaining the heart's function as a pump. The left ventricle no longer has the capacity to hold normal volumes of blood during diastole. As a result, the left atrium dilates from the increased pressure and volume of blood backing up into the lungs.
  
*Common in cats
 
===Signalment===
 
  
Dogs: Rare
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==Signalment==
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This heart disease is rare in dogs but is the '''most common cardiac disease in cats'''. It more frequently occurs in Persians and Siamese breeds of cat. It is thought to be inherited in Maine Coon cats.
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<br>
  
Cats: Pedigrees (e.g. Persians, Maine Coons) & mixed breeds; Occurs in young pedigrees and young to old mixed breeds; Male>Female
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== Clinical Signs ==
  
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The disease can often be present without clinical signs (asymptomatic).
  
===Description===
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There may be hindlimb paresis or weakness, if saddle [[Thrombosis|thrombus]] (cats) occurs due to this disease.
  
*Left ventricular concentric hypertrophy without an identifiable cause is known as hypertrophic cardiomyopathy.  The ventricular myocardium becomes so thick that the lumen is reduced to a size that is not compatible with maintaining the heart's function as a pump. The left ventricle no longer has the capacity to hold normal volumes of blood during diastole.  As a result, the left atrium dilates from the increased pressure and volume of blood backing up into the lungs.  
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There will usually be signs of [[Heart Failure, Left-Sided|left-sided heart failure]]. Tachycardia, [[:Category:Arrhythmia|arrhythmias]] and dyspnoea can also be seen.
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<br>
  
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== Diagnosis ==
  
===Diagnosis===
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Physical examination and auscultation will reveal a systolic murmur and ventricular arrhythmias.
  
====History & Clinical Signs====
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Radiography of the thorax will show a degree of left atrial enlargement, a generally enlarged heart and pulmonary congestion & edema.
  
-Asymptomatic
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On Electrocardiography (ECG), there will often be presence of a '''tall R wave and a wide QRS complex'''. Ventricular arrhythmias, conduction disturbances and sinus tachycardia may also be seen.
  
-Hindlimb paresis or weakness (saddle thrombus see in cats)
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Upon Echocardiography, left ventricular concentric hypertrophy, left atrial enlargement and mitral valve insufficiency are commonly seen with this condition. The chamber size will appear dramatically reduced.
  
-Signs of left-sided heart failure
 
  
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== Treatment ==
  
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It is necessary to treat the individual symptoms, as there is no treatment for the condition.
  
====Physical Exam:====
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Drugs with contraindications include arterial vasodilators and positive inotropes.
  
-Systolic murmur
 
  
-Ventricular arrhythmias
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== Prognosis ==
  
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Poor for symptomatic cats.
  
===Radiography====
 
  
-Left atrial enlargement
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{{Learning
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|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis00924.asp, Hypertrophic cardiomyopathy]
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|flashcards = [[Myocardial Pathology Flashcards]]
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}}
  
-Enlarged heart
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== References ==
  
-Pulmonary congestion & edema
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Ettinger, S.J. and Feldman, E. C. (2000)''' Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat '''Volume 2 (Fifth Edition) ''W.B. Saunders Company''
  
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Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2) ''W.B. Saunders Company''
  
===Electrocardiography (ECG)====
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Fossum, T. W. et. al. (2007) '''Small Animal Surgery '''(Third Edition) ''Mosby Elsevier ''
  
-Tall R wave
 
 
-Wide QRS
 
 
-Ventricular arrhythmias
 
 
-Conduction disturbances
 
 
-Sinus tachycardia
 
 
 
====Echocardiography====
 
 
-Left ventricular concentric hypertrophy
 
 
-Left atrial enlargement
 
 
-Mitral valve insufficiency
 
 
 
===Treatment===
 
 
-Treat the individual symptoms
 
 
Contraindications: Arterial Vasodilators; Positive Inotrops
 
  
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{{review}}
  
===Prognosis===
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{{OpenPages}}
  
-Poor for symptomatic cats
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[[Category:Cardiomyopathy]] [[Category:Cardiac Diseases - Cat]][[Category:Cardiac Diseases - Dog]]
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[[Category:Expert_Review]]
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[[Category:Cardiology Section]]

Latest revision as of 14:37, 6 September 2015


Introduction

Left ventricular concentric hypertrophy without an identifiable cause is known as hypertrophic cardiomyopathy. The ventricular myocardium becomes so thick that the lumen is reduced to a size that is not compatible with maintaining the heart's function as a pump. The left ventricle no longer has the capacity to hold normal volumes of blood during diastole. As a result, the left atrium dilates from the increased pressure and volume of blood backing up into the lungs.


Signalment

This heart disease is rare in dogs but is the most common cardiac disease in cats. It more frequently occurs in Persians and Siamese breeds of cat. It is thought to be inherited in Maine Coon cats.

Clinical Signs

The disease can often be present without clinical signs (asymptomatic).

There may be hindlimb paresis or weakness, if saddle thrombus (cats) occurs due to this disease.

There will usually be signs of left-sided heart failure. Tachycardia, arrhythmias and dyspnoea can also be seen.

Diagnosis

Physical examination and auscultation will reveal a systolic murmur and ventricular arrhythmias.

Radiography of the thorax will show a degree of left atrial enlargement, a generally enlarged heart and pulmonary congestion & edema.

On Electrocardiography (ECG), there will often be presence of a tall R wave and a wide QRS complex. Ventricular arrhythmias, conduction disturbances and sinus tachycardia may also be seen.

Upon Echocardiography, left ventricular concentric hypertrophy, left atrial enlargement and mitral valve insufficiency are commonly seen with this condition. The chamber size will appear dramatically reduced.


Treatment

It is necessary to treat the individual symptoms, as there is no treatment for the condition.

Drugs with contraindications include arterial vasodilators and positive inotropes.


Prognosis

Poor for symptomatic cats.



Hypertrophic Cardiomyopathy Learning Resources
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Flashcards
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Myocardial Pathology Flashcards


References

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company

Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2) W.B. Saunders Company

Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier




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