Difference between revisions of "Endocardiosis"

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(Redirected page to Degenerative Mitral Valve Disease)
 
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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''
 
 
 
*Common lesion in heart valve (dog)
 
 
 
*Most often in the mitral valve
 
 
 
*Rare in cats
 
 
 
 
 
====Signalment====
 
 
 
*Age: Middle Age to Old dogs
 
 
 
*Sex: Males
 
 
 
*Genetics & Predisposed Breeds: Most common in smaller breeds (Chihuahua, Boston Terrier, Poodle, Pomeranian); Large Breeds (German Shepherd, Collies)
 
 
 
 
 
====Description====
 
 
 
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.
 
 
 
 
 
====Diagnosis====
 
 
 
====Clinical Signs====
 
 
 
Signs depend on stage of disease:
 
 
 
-Coughing
 
 
 
-Syncope
 
 
 
-Weight loss
 
 
 
-Pale or cyanotic mucus membranes
 
 
 
-Prolonged capillary refill time
 
 
 
-'''Left-sided heart failure signs:'''
 
 
 
*exercise intolerance
 
 
 
*weakness
 
 
 
*dyspnoea
 
 
 
*inappetance
 
 
 
*lethargy
 
 
 
-'''Right-sided heart failure signs:'''
 
 
 
*hepatomegaly
 
 
 
*jugular pulses & distension
 
 
 
*pleural effusion
 
 
 
*ascites
 
 
 
*peripheral edema
 
 
 
 
 
====Physical Exam====
 
 
 
-Incidental finding: systolic click heard in asymptomatic animals
 
 
 
-Murmur over the left heart apex
 
 
 
-Snaps, crackles, pops heard if pulmonary edema is present
 
 
 
-Muffled heart sounds in the presence of pleural/pericardial fluid
 
 
 
 
 
====Radiography====
 
 
 
-Left sided heart enlargement
 
 
 
-(+/-) Left atrial enlargement (DV view appears at 2-3 o'clock position)
 
 
 
-(+/-) Left ventricular enlargement
 
 
 
-(+/-) Dorsal displacement of trachea
 
 
 
-(+/-) Bronchial compression
 
 
 
-Pulmonary venous congestion and/or edema
 
 
 
-(+/-) Right-sided signs (distended caudal vena cava, ascites, pleural effusion, heptaomegaly)
 
 
 
 
 
 
 
====Electrocardiography (ECG)====
 
 
 
-Left atrial enlargement pattern
 
 
 
-Left ventricular enlargement pattern
 
 
 
-Rhythm disturbances (supraventricular arrhythmias: atrial premature complexes, atrial tachycardia, and ventricular rhythm disturbances)
 
 
 
 
 
====Echocardiography====
 
 
 
-Irregularities of the valves affected (e.g. thickening, shortening, and/or prolapse of the valve leaflets)
 
 
 
-Abnormal valve movements & valve regurgitation
 
 
 
-Left atrial enlargement (wide P wave)
 
 
 
-Left ventricular dilation (tall R wave, wide QRS complex)
 
 
 
====Early Stage of disease====
 
 
 
*Normal to increased fractional shortening of the myocardium
 
 
 
====Later Stage of disease====
 
 
 
*Decreased fractional shortening of the myocardium
 
 
 
 
 
====Treatment====
 
 
 
*Left-sided heart failure treatment given at the onset of clinical signs.
 
 
 
*Right-sided heart failure treatment given at the onset of clinical signs.
 
 
 
*Symptomatic treatments are also given if clinical signs persist while the animal is on heart failure medications.
 
 
 
 
 
=====Complications=====
 
 
 
*Arrhythmias
 
 
 
*Bronchial Compression
 
 
 
*Ruptured Chordae Tendineae
 
 
 
*Atrial Rupture
 
 
 
 
 
====Prognosis====
 
 
 
-Asymptomatic patients may live for many years.
 
 
 
-Some patients remain stable for years on heart failure medications
 

Latest revision as of 10:02, 1 July 2016