Acquired Valvular Disease I- CardioRush

Dogs, pigs, humans, cat, horse
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Terms in this set (56)
Dogs, pigs, humans, cat, horse
What species can get myxomatous degeneration causing acquired valvular disease?
Myxomatous degeneration, fibrosis/calcification, immune mediated, neoplastic, infectious, drug induced
What are the various causes of acquired valve disease?
Mucopolysaccharide
What infiltrates the valve in myxomatous degeneration?
Endocarditis, rhumatic fever (humans)
What infectious diseases can cause acquired valvular disease?
Degenerative mitral valve disease
What is DMVD?
Endocardiosis, myoxomatous degeneration, chronic valvular disease
What are some other names for DMVD?
Itis is inflammation, iosis is thickening and degeneration
What is the difference between endocardiosis and endocarditis?
DMVD
What is the most common heart disease in dogs?
75-80%
What percentage of dogs with heart disease are affected by DMVD?
False (it is unknown)
True or false: the etiology of DMVD is well understood
NoDoes DMVD predispose to endocarditis?MitralWhat valve is most commonly affected by valve degeneration?30%What percentage of DMVD cases have tricuspid involvement?AorticOther than the tricuspid valve, what other valve can occasionally be affected by DMVD?Small to medium breedsWhat types of dogs is DMVD most common in?CKCS, poodle, chihuahua, maltese, mini schnauzer, dachshund, cockersWhat small breeds of dogs are most likely to get DMVD?GSD, Dobie, Great DaneWhat large breeds of dogs are occasionally affected by DMVD?TrueTrue or false: there is an inherited component identified for DMVD in some breeds, such as CKCS and dachshund2-3 years oldWhen does DMVD usually begin?Slowly, unpredictably progressive, long asymptomatic phase, males progress more rapidlyWhat are the characteristics of the progression of DMVD?CHFWhat occurs later in disease in the most severely affected dogs with DMVD?Anterior, posterior mitral leaflets, chordae tendinae, papillary muscles, mitral annulus, LV wall, LA wallWhat are the components of the mitral valve apparatus?Primary regurg causes enlargement, annulus stretches, worsens regurgHow does the mitral annulus contribute to progression of DMVD severity?Atrialis, spongiosa, fibrosa, ventricularisWhat are the 4 layers of the valve histologically?Valvular interstitial cells, valvular endothelial cellsWhat are the 2 predominant cell types in the mitral valve?AtrialisWhat layer of the valve is mostly elastic fibers supported by thin later of connective tissue and smooth muscle, lined with endothelium?SpongiosaWhat layer of the valve is loose connective collagen, valvular interstitial cells, and elastic fibers surrounded by mucopolysaccharide ground substance?SpongiosaWhat layer of the valve is most affected by DMVD?FibrosisWhat layer of the valve is the dense layer of compact collagen that is continuous with chordae tendinae and mitral annulus?FibrosaWhat layer of the valve is the tough skeletal layer?VentricularisWhat layer of the valve is mostly collagen similar to the atrialis, but without smooth muscle, and acts as the layer between the fibrosa and endothelial layer?Valvular interstitial cellsWhat is the main cell type in valve ECM?Transform into active cells, deposit GAGsWhat is the role of valvular interstitial cells in development of DMVD?FibrosaWhat valve layer gets out of control and is extremely unorganized in DMVD?Thickening, shortening, fibrosis, areas showing bulging, prolapse towards atrial sideWhat are the characteristics of the valve on gross pathology in DMVD?Area of apposition of leafletsWhere does myxomatous change begin on the valve in DMVD?Elongated, thickened, rupturedWhat are the changes seen in gross pathology in the chordae tendinae in DMVD?Secondary LA dilation, eccentric LV hypertrophy, atrial jet lesions, endocardial splittingWhat are the changes seen in gross pathology in the LA and LV in DMVD?Endocardial splittingWhat is a precursor to atrial rupture?CT ruptureWhat issue with the chordae tendinae is common in dogs with DMVD?Sudden, dramatic increase in mitral regurg, worsening CHFWhat is the result of CT rupture on the heart in DMVD?Endocardial splittingWhat is this gross pathologic change?False (depends on how large the tear, speed of repair, aggressive treatment)True or false: atrial tears are always fatalEndocardial linear scar/fibrosis, DMVD rough tissue where mitral regurg is hitting the wallHow is a jet lesion different from endocardial splitting?TrueTrue or false: the chordae tendinae along with the mitral and tricuspid leaflets can all be affected by myxomatous degeerationFalse (it is not inflammatory, but inappropriate GAG deposition)True or false: myxomatous disease is a highly inflammatory conditionAltered morpholoy, activation of valvular interstitial cellsWhat characterizes myxomatous degeneration of the mitral valve?Alcian blue: acidWhat special stain targets mucopolysaccharides?Thickening of spongiosaWhat is the first histologic change in DMVD?Early endothelial proliferation, later endothelial damage on atrialis side, dissolution of collagenWhat histologic changes occur after thickening of the spongiosa in DMVD?ArteriosclerosisWhat change in the vessels has been linked to DMVD?Narrowing of vesselsWhat is arteriosclerosis?Cholesterol plaquesWhat is atherosclerosis?Lungs, myocardium, kidneysIn what location do vessels narrow in DMVD due to arteriosclerosis?Myocardial ischemia, necrosis, fibrosis, ventricular arrhythmiasWhat is a possible complication of DMVD due to arteriosclerosis?Myxomatous degeneration of valve substance, elongation of chordae tendinae, thickening of valve leaflets, distortion of architecture, prolapse, mitral regurgitation, eccentric ventricular remodeling, annular dilation, CHFWhat is the overall pathogenesis of DMVD?