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Arrhythmogenic Right Ventricular Cardiomyopathy - Feline Cardiomyopathies (view source)
Revision as of 17:57, 17 October 2013
, 17:57, 17 October 2013no edit summary
====Differential Diagnoses====
====Differential Diagnoses====
The main differential for ARVC in cats is tricuspid dysplasia, which causes severe volume overload to the right ventricle and right atrium. Colour flow doppler interrogation of the tricuspid valve in ARVC often reveals a mild central jet of tricuspid regurgitation secondary to annular dilation. The tricuspid valve appeas structurally normal. In comparison, a cat with tricuspid dysplasia would have significant tricuspid regurgitation and a structurally abnormal tricuspid valve with clubbed, thickened leaflets and a short, thickened chordae tendinae combined with abnormal papillary muscles. The distinction is important because prognosis for ARVC is grave compared with tricuspid dysplasia.
The main differential for ARVC in cats is tricuspid dysplasia, which causes severe volume overload to the right ventricle and right atrium. Colour flow doppler interrogation of the tricuspid valve in ARVC often reveals a mild central jet of tricuspid regurgitation secondary to annular dilation. The tricuspid valve appeas structurally normal. In comparison, a cat with tricuspid dysplasia would have significant tricuspid regurgitation and a structurally abnormal tricuspid valve with clubbed, thickened leaflets and a short, thickened chordae tendinae combined with abnormal papillary muscles. The distinction is important because prognosis for ARVC is grave compared with tricuspid dysplasia.
===Electrocardiography (ECG)===
Ventricular arrhythmias are common in cats with ARVC and can lead to syncope or sudden death. The arrhythmias are caused by macroreentrant circuits that develop in regions of fibrofatty replacement of cardiomyocytes.
* Ventricular premature complexes (VPCs)
* Ventricular tachycardia
* Atrial fibrillation
* Right bundle branch block
==Treatment==
==Treatment==
Positive inotropes, such as pimobendan, may be required to treat severe right ventricular myocardial failure. Congestive heart failure is treated with furosemide and an ACE inhibitor such as Benezepril. Anticoagulant therapy is almost always indicated because cats with ARVC often have marked right atrial dilation which puts them at high risk of pulmonary thromboembolism.
Antiarrhythmic therapy may be necessary for treatment of severe ventricular or supraventricular tachyarrhythmias.
==Prognosis==
==Prognosis==
Prognosis for cats with ARVC is grave. In one case series of 12 cats with ARVC, 75% of cats died or where euthanised due to right heart failure or thromboembolism with a median survival time of 1 month in CHF cases.
==References==
==References==
* Fox PR et al. Spontaneous occurence of arrhythmogenic right ventricular cardiomyopathy in the domestic cat: a new animal model of human disease. Circulation, 102:1863, 2000
[[Category:Cardiology Section]]