Difference between revisions of "Tricuspid Valve Dysplasia"

Revision as of 10:45, 22 September 2008

CARDIOLOGY ()Map CARDIOVASCULAR CONDITIONS (Map)

Common in dogs & cats

Rare in large animals

Horses do get tricuspid atresia

Signalment

Genetics & Predisposed Breeds: Labrador Retrievers, German Shepherds, Boxers, Great Danes

Description

Congenital malformation of the tricuspid valve (right atrioventricular valve) and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets) results in tricuspid stenosis (narrowing) or regurgitation (insufficiency)

Tricuspid valve dysplasia leads to increased volume load on the right atrium and ventricle towards the end of diastole.

A stenotic tricuspid valve can limit ventricular filling during diastole.

Increased pressure as a result of increased volume can cause right-sided congestive heart failure.

Diagnosis

History & Clinical Signs

-Exercise intolerance

-Dyspnea

-Weight Loss

-Poor appetite

-Abdominal distension

Physical Exam

-Right-sided soft systolic murmur (tricuspid regurgitation)

-Right-sided diastolic murmur

-Jugular pulses & distension (severe case)

-Femoral pulses are normal to weak

-Signs of right-sided congestive heart failure (severe case)

Radiographic Findings

-Right atrial and right ventricular enlargement

-Caudal vena cava enlargement

-Pulmonary underperfusion

-Signs of right sided heart failure

Echocardiographic Findings

-Right ventricular and atrial dilation

-Abnormalities of tricuspid valve

Doppler shows tricuspid regurgitation and/or stenosis

Electrocardiographic (ECG)

-Classic signs of right atrial and ventricular enlargement

-Atrial arrhythmias

-Ventricular conduction problems

Treatment

Palliative Treatment

-Pharmacologically control right sided congestive heart failure

-Pharmacologically control arrhythmias

-Thoracentesis when needed to relieve pleural effusion

-Abdominocentesis when needed to relieve peritoneal effusion

Prognosis

Mild/Moderate Cases

-Normal life

Severe Cases

-Poor (However, if heart failure is controlled these patients can live several years.)

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-{{OpenPagesTop}}
+{{review}}
-== Introduction ==
+{{toplink
+|backcolour =
+|linkpage =Cardiology - WikiClinical
+|linktext =Cardiology
+|sublink1=Cardiovascular Conditions - WikiClinical
+|subtext1=CARDIOVASCULAR CONDITIONS
+|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
+|pagetype=Clinical
+}}
+<br>
+*Common in dogs & cats
+*Rare in large animals
+*Horses do get tricuspid atresia
+===Signalment===
+Genetics & Predisposed Breeds: Labrador Retrievers, German Shepherds, Boxers, Great Danes
+===Description===
-The condition should be described as a congenital malformation of the tricuspid valve (right atrioventricular valve) and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets) resulting in tricuspid stenosis (narrowing) or regurgitation (insufficiency). Tricuspid valve dysplasia leads to increased volume load on the right atrium and ventricle towards the end of diastole. A stenotic tricuspid valve can limit ventricular filling during diastole and increased pressure as a result of increased volume can cause [[Heart Failure, Right-Sided|right-sided congestive heart failure]].
+*Congenital malformation of the tricuspid valve (right atrioventricular valve) and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets) results in tricuspid stenosis (narrowing) or regurgitation (insufficiency)
-==Signalment==
+*Tricuspid valve dysplasia leads to increased volume load on the right atrium and ventricle towards the end of diastole.
-This is a condition which is common in dogs and cats, quite common in horses and rare in large animals. Predisposed breeds of dog include the Labrador Retrievers, German Shepherds, Boxers and Great Danes. It is the second most common congenital abnormality seen in cats.
+*A stenotic tricuspid valve can limit ventricular filling during diastole.
+*Increased pressure as a result of increased volume can cause right-sided congestive heart failure.
-== Clinical Signs ==
+===Diagnosis===
+====History & Clinical Signs====
-Often presence of a [[Heart Murmurs|murmur]] on physical exam is the only clinical sign. Other clinical signs vary depending on the severity of the disease but will include exercise intolerance, dyspnea, weight loss, poor appetite and abdominal distension.
+-Exercise intolerance
-== Diagnosis ==
+-Dyspnea
-Physical examination findings will reveal a right-sided soft systolic murmur (tricuspid regurgitation), a right-sided diastolic murmur and jugular pulses and distension in severe cases. Femoral pulses are usually normal to weak and there may be signs of right-sided congestive heart failure in severe cases.
+-Weight Loss
-Radiographic findings may include right atrial and right ventricular enlargement, caudal vena cava enlargement, pulmonary underperfusion and signs of right sided heart failure.
+-Poor appetite
-Echocardiographic findings include right ventricular and atrial dilation and abnormalities of the tricuspid valve. Doppler shows tricuspid regurgitation and/or stenosis.
+-Abdominal distension
-Electrocardiographic (ECG) study can show classic signs of right atrial and ventricular enlargement, atrial arrhythmias as well as ventricular conduction problems.
+====Physical Exam====
+-Right-sided soft systolic murmur (tricuspid regurgitation)
-== Treatment ==
+-Right-sided diastolic murmur
-Treatment is usually palliative. Signs of right sided congestive heart failure can be controlled pharmacologically, as can [[:Category:Arrhythmia|arrhythmias]]. Thoracocentesis should be performed when needed to relieve pleural effusion. Abdominocentesis when needed to relieve peritoneal effusion.
+-Jugular pulses & distension (severe case)
+-Femoral pulses are normal to weak
-== Prognosis ==
+-Signs of right-sided congestive heart failure (severe case)
-Mild to moderate cases can lead a normal life. Severe cases have a poor prognosis, however, if heart failure is controlled these patients can live several years.
+====Radiographic Findings====
+-Right atrial and right ventricular enlargement
-== References ==
+-Caudal vena cava enlargement
-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
+-Pulmonary underperfusion
-Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2), W.B. Saunders Company
+-Signs of right sided heart failure
-Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition), Mosby Elsevier
+====Echocardiographic Findings====
-Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial
+-Right ventricular and atrial dilation
-Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition), Mosby Elsevier.
+-Abnormalities of tricuspid valve
+Doppler shows tricuspid regurgitation and/or stenosis
-{{review}}
+====Electrocardiographic (ECG)====
+-Classic signs of right atrial and ventricular enlargement
+-Atrial arrhythmias
+-Ventricular conduction problems
+===Treatment===
+Palliative Treatment
+-Pharmacologically control right sided congestive heart failure
+-Pharmacologically control arrhythmias
+-Thoracentesis when needed to relieve pleural effusion
+-Abdominocentesis when needed to relieve peritoneal effusion
+===Prognosis===
+'''Mild/Moderate Cases'''
+-Normal life
-{{OpenPages}}
+'''Severe Cases'''
-[[Category:Cardiovascular_System_-_Developmental_Pathology]] [[Category:Expert_Review]] [[Category:Cardiac_Diseases_-_Dog]] [[Category:Cardiac_Diseases_-_Cat]] [[Category:Cardiac_Diseases_-_Horse]]
+-Poor (However, if heart failure is controlled these patients can live several years.)
-[[Category:Cardiology Section]]