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| − | {{review}}
| + | #redirect[[Degenerative Mitral Valve Disease]] |
| − | {{toplink
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| − | |backcolour =
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| − | |linkpage =Cardiology - WikiClinical
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| − | |linktext =Cardiology
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| − | |sublink1=Cardiovascular Conditions - WikiClinical
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| − | |subtext1=CARDIOVASCULAR CONDITIONS
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| − | |maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
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| − | |pagetype=Clinical
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| − | }}
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| − | {{dog}}{{cat}}
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| − | | |
| − | <br>
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| − | [[Image:endocardiosis3.jpg|right|thumb|125px|<small><center>'''Endocardiosis'''. Courtesy of A. Jefferies</center></small>]] | |
| − | ''a.k.a. myxomatous mitral valve disease, mitral insufficiency, mitral regurgitation, chronic valvular disease''
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| − | *Common lesion in heart valve (dog)
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| − | *Most often in the mitral valve
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| − | *Rare in cats
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| − | ====Signalment====
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| − | *Age: Middle Age to Old dogs
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| − | *Sex: Males
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| − | *Genetics & Predisposed Breeds: Most common in smaller breeds (Chihuahua, Boston Terrier, Poodle, Pomeranian); Large Breeds (German Shepherd, Collies)
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| − | ====Description====
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| − | Valvular insufficiency due to thickening and shortening of the valve leaflets. Consequently, during systole a small stream of blood passes back into the left atrium causing a white jet lesion where the blood contacts the atrial wall and atrial dilation. Advanced cases progress to left sided (congestive) heart failure and then to concurrent right sided heart failure.
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| − | ====Diagnosis====
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| − | ====Clinical Signs====
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| − | Signs depend on stage of disease:
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| − | -Coughing
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| − | -Syncope
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| − | -Weight loss
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| − | -Pale or cyanotic mucus membranes
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| − | -Prolonged capillary refill time
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| − | -'''Left-sided heart failure signs:'''
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| − | *exercise intolerance
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| − | *weakness
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| − | *dyspnoea
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| − | *inappetance
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| − | *lethargy
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| − | -'''Right-sided heart failure signs:'''
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| − | *hepatomegaly
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| − | *jugular pulses & distension
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| − | *pleural effusion
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| − | *ascites
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| − | *peripheral edema
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| − | ====Physical Exam====
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| − | -Incidental finding: systolic click heard in asymptomatic animals
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| − | -Murmur over the left heart apex
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| − | -Snaps, crackles, pops heard if pulmonary edema is present
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| − | -Muffled heart sounds in the presence of pleural/pericardial fluid
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| − | ====Radiography====
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| − | -Left sided heart enlargement
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| − | -(+/-) Left atrial enlargement (DV view appears at 2-3 o'clock position)
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| − | -(+/-) Left ventricular enlargement
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| − | -(+/-) Dorsal displacement of trachea
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| − | -(+/-) Bronchial compression
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| − | -Pulmonary venous congestion and/or edema
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| − | -(+/-) Right-sided signs (distended caudal vena cava, ascites, pleural effusion, heptaomegaly)
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| − | ====Electrocardiography (ECG)====
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| − | -Left atrial enlargement pattern
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| − | -Left ventricular enlargement pattern
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| − | -Rhythm disturbances (supraventricular arrhythmias: atrial premature complexes, atrial tachycardia, and ventricular rhythm disturbances)
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| − | ====Echocardiography====
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| − | -Irregularities of the valves affected (e.g. thickening, shortening, and/or prolapse of the valve leaflets)
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| − | -Abnormal valve movements & valve regurgitation
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| − | -Left atrial enlargement (wide P wave)
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| − | -Left ventricular dilation (tall R wave, wide QRS complex)
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| − | ====Early Stage of disease====
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| − | *Normal to increased fractional shortening of the myocardium
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| − | ====Later Stage of disease====
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| − | *Decreased fractional shortening of the myocardium
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| − | ====Treatment====
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| − | *Left-sided heart failure treatment given at the onset of clinical signs.
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| − | *Right-sided heart failure treatment given at the onset of clinical signs.
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| − | *Symptomatic treatments are also given if clinical signs persist while the animal is on heart failure medications.
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| − | =====Complications=====
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| − | *Arrhythmias
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| − | *Bronchial Compression
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| − | *Ruptured Chordae Tendineae
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| − | *Atrial Rupture
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| − | ====Prognosis====
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| − | -Asymptomatic patients may live for many years.
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| − | -Some patients remain stable for years on heart failure medications
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