Cardiomyopathy I- CardioRush

Mechanical or electrical dysfunction, usually ventricular hypertrophy or dilation, frequently genetic
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Mechanical or electrical dysfunction, usually ventricular hypertrophy or dilation, frequently genetic
What are the characteristics of cardiomyopathy that groups these myocardial diseases together?
False (may be confined to the heart, or may be part of a generalized systemic disorder)
True or false: all cardiomyopathy diseases are only confined to the heart
Weakness, exercise limitation, syncope, progressive heart failure, cardiovascular death
What are some of the signs that commonly accompany cardiomyopathies?
DCM, HCM, Restrictive, arrhythmogenic RVCM
What are the 4 big categories of cardiomyopathy?
Chamber dilation, thin walls, systolic dysfunction (sometimes diastolic as well)
What are the defining features of DCM?
Concentric hypertrophy, small cavity, possible LVOTO, diastolic dysfunction (sometimes systolic as well)
What are the defining features of HCM?
Endocardial fibrosis, LA enlargement, usually diastolic dysfunction
What are the defining characteristics of restrictive cardiomyopathy?
HCM
What is the cardiomyopathy?
Image: HCM
DCM
What is the cardiomyopathy?
Image: DCM
Restrictive
What is the cardiomyopathy?
Image: Restrictive
Scar tissue formation, LA enlargementWhat are the gross changes that occur in restrictive cardiomyopathy?False (Can be primary or secondary)True or false: cardiomyopathy can only be primary, not secondaryMyocardial disease primarily affecting heart, genetic cause likely but includes nongenetic and acquired diseases as wellWhat are the features of primary (intrinsic) cardiomyopathy?Myocardial disease secondary to systemic, multiorgan diseaseWhat are the characteristics of secondary (extrinsic) cardiomyopathy?Ischemic, doxorubicin inducedWhat are 2 examples of secondary (extrinsic) cardiomyopathy?HCM, ARVC, LVNC, glycogen storageWhat are some genetic causes of primary (intrinsic) cardiomyopathy?DCM, restrictiveWhat are 2 examples of mixed genetic and acquired causes of primary (intrinsic) cardiomyopathy?Inflammation, stress induced, peripartum, tachycardia inducedWhat are some examples of primary (intrinsic) acquired cardiomyopathy?HCM, DCM, RCM, ARVCM, myocarditis, tachycardia induced CMWhat are the main cardiomyopathies in vet medicine?CMWhat is the most common heart disease in cats?False (that is the percentage in dogs. It makes up 70-90% of all feline heart disease)True or false: cardiomyopathy makes up 12-30% of all feline heart diseaseCMWhat is the second most common heart disease in dogs, and the most common heart disease in large breed dogs?CHF, arrhythmias, thromboembolismWhat are the 3 major clinical manifestations of cardiomyopathy?Dyspnea, exercise intoleranceWhat are the main signs associated with CHF from CM?Syncope, episodic weakness, sudden deathWhat are the main signs associated with cardiac arrhythmias from cardiomyopathy?Acute lameness, dyspneaWhat are the main signs associated with thromboembolism in cardiomyopathy?Dilation of all 4 chambers, L heart changes may predominate, thinning of IVS, LV, RV walls, enlarged AV ring and secondary valve insufficiency, mild endocardial or interstitial fibrosis, edemaWhat are the most common gross pathologic findings associated with DCM?False (may manifest as LCHF or biventricular CHF)True or false: DCM always manifests are RCHFAscites, pleural or pericardial effusion, pulmonary edema, hepatomegalyWhat are the signs of CHF associated with DCM?Mild inflammation, myocyte degeneration, lipid replacement in LVWhat are some histologic changes that can be seen in a Doberman with DCM?Systolic dyfunctionWhat is the hallmark of pathophysiology associated with DCM?False (The hallmark is systolic dysfunction but diastolic dysfunction is present in most cases with CHF)True or false: Diastolic dysfunction is rarely present in DCM, the hallmark is systolic dysfunctionDilation of cardiac chambers, systolic dysfunction, neuroendocrine compensatory responses, dilation causes secondary AV regurg, CHF may manifest as LCHF, RCHF, or biventricularWhat is the pathophysiology of DCM?SNS activation, RAAS, vasopressin, ANP, BNP releaseWhat are some examples of the neuroendocrine responses that occur with DCM?TrueTrue or false: the etiology of DCM is heterogenous, we don't always know the exact cause or causesFalse (Diagnosed based on end stage of myocyte damage and dysfunction)True or false: we are able to diagnose DCM based on early changes on echoStriatinWhat gene has been implicated in DCM in boxers?PDK4, Dobie DCM 2 geneWhat genes have been implicated in DCM in Dobermans?Taurine, carnitine, BEG dietsWhat are some possible contributors to DCM development, but the exact role isn't known?Large breed, male more common, middle age of olderWhat is the most common signalment of DCM?Dobie, Boxer, cocker spaniel, Dalmatian, PWDWhat dog breeds most commonly get DCM?Dobie, BoxerWhat dog breeds get their own version of DCM?Variable cough, dyspnea worse at night, syncope, weakness, collapse, anorexia, exercise intolerance, weight lossWhat are some common presenting complaints with DCM?BronchitisWhat is a common misdiagnosis for CHF from cardiomyopathies?NT proBNPWhat can you do to differentiate bronchitis from early CHF on radiographs and signs?Soft 2-3/6 systolic murmur from mitral or tricuspid dysfunction, S3 gallop, arrhythmias commonWhat are the common cardiac auscultation findings with DCM?HR variable, faster if near CHF or arrhythmia present, weak arterial pulses an apex beat, MM pallor, delayed CRTWhat are the PE findings consistent with DCM?Pulmonary crackles, brassy cough on tracheal palpation, jugular vein distention, hepatojugular refluxWhat are the signs of CHF that can occur with DCM?Weight loss, cool limbs, weakness, low temp, azotemiaWhat are signs of low forward output from the heart in DCM found on PE?DobieIn what breed is cardiogenic shock most common?Generalized cardiomegaly, tracheal elevation, LAE, perihilar interstitial or bronchial pattern, sometimes veins larger than arteries, pleural effusion, enlarged CVC or liverWhat are the classic findings on radiographs consistent with DCM?Normal heart size, trachea has distal bend, no atrial enlargement, radiolucent lungsWhat characteristics of these radiographs make them normal?Cardiomegaly, LVE, tracheal elevationWhat are the radiographic findings?RAEWhat is the yellow arrow pointing to?LVEWhat is the red arrow pointing to?Mild LAE, interstitial patternWhat are the radiographic findings?CHF, small volume pleural effusion, air bronchogramsWhat are the radiographic findings?P mitrale from LAE, LVE pattern in most breeds, arrhythmiasWhat ECG changes are common in DCM?A fib, APCsWhat arrythmias are most likely in giant breed dogs with DCM?Ventricular arrhythmiasWhat arrhythmias are most common in Boxers and Dobies with DCM?Dilation of all cardiac chamber, esp LV, reduced fractional shortening (<25%), thinned LV walls, LAE esp in CHF, AV regurgWhat findings on echo are definitive for DCM?LV and LA dilation, thin LV free wallWhat are the echo findings and what is it consistent with?Marked reduction in fractional shortening, DCMWhat is the findings on M mode?30%What is the normal fractional shortening?Marked LAEWhat is the finding on echo?Chem, urinalysis, HW status, taurine, BP, NT proBNPWhat are some lab tests that can be helpful in diagnosing DCM?Baseline renal and electrolyte values, hepatic congestion can increase LEsWhy is a blood chemistry helpful in diagnosing DCM?Baseline values before diureticWhy is it helpful to have urinalysis when diagnosing DCM?False (depends on the breed, some breeds or diets are more likely to get taurine deficiency)True or false: you should always get taurine levels as part of a workup for DCMFurosemide, ACE inhibitor, pimo, possible antiarrhythmic, additional diuretic, supplement deficiencies, diet, exercise limitationWhat are the classic drugs we use to treat DCM?