Cardiomyopathy III- CardioRush

CMs, dynamic RVOTO, systemic hypertension, anemia, hyperthyroidism, congenital heart diseaseWhat are the differential diagnoses for cats that have cardiac murmurs?Mutations, environmentWhat are the likely contributors to developing HCM?Sarcomeric protein missense mutation, myosin binding protein C in Maine Coon and RagdollsWhat specific mutations have been found to contribute to developing HCM?TrueTrue or false: in most cases of feline heart disease, the first clinical manifestation is a crisis eventCHF, ATE, syncope, sudden deathWhat are some crisis events that cats with HCM can present with?Any breed, any age, male more commonWhat is the typical signalment of cats with HCM?False (cough typically absent in cats with HCM)True or false: cough is a common presenting complaint in feline HCMDyspnea, open mouth breathing, lethargy, weakness, hiding, anorexia, vomiting, syncope, limb weaknessWhat are some signs that may occur with HCM?Stress, anesthesia, fluids, steroidsWhat are some possible events that may occur that may precipitate CHF in occult HCM?Cardiac murmur on sternal border, S4 gallop, arrhythmia, resp distress, weak pulses, ATE or RCHF signsWhat are the findings on the PE in HCM?Atrial contraction into stiff ventricleWhat causes an S4 gallop?LeftWhat side ventricle is the origin of this VPC?VPCs, v tach, a fibWhat are some ECG findings consistent with HCM?Identify cardiomegaly, CHF, signs of volume overload, thoracic diseasesWhat are thoracic radiographs used for in cats that present with dyspnea?CardiomegalyWhat is the radiographic finding?Biatrial enlargement (valentine heart shape characteristic of HCM)What is the radiographic finding?False (must use lateral view to measure, but can be taken on DV on long and short axis)True or false: VHS can only be taken on the lateral view<3.4What is a normal VHS in a cat?Interstitial to alveolar infiltrates from pulmonary edemaWhat is the radiographic finding?False (can be perihilar or patchy pulmonary infiltrates)True or false: Pulmonary edema is consistently perihilar in cats with CHFPatchy pulmonary infiltratesWhat is the radiographic finding?Pulmonary edema, small volume pleural effusion, biventricular CHFWhat is the radiographic finding?Pleural effusionWhat is the radiographic finding?Chronic issueWhat does it mean if the caudal lung lobes are rounded with pleural effusion?EchoWhat is the best diagnostic test for feline HCM?LVFW or IVS >0.6cm in diastole, 0.9cm in systoleWhat are the M mode cut off measurements for diagnosing HCM?LAWhat chamber size correlated with risk of ATE?HCMThe following is an echo image at the end of systole. What is the diagnosis?True (can fit more than 2.5x aortas inside the LA)True or false: this LA is mildly enlargedSmokeWhat is present in the LA?Turbulent RBCs and aggregation, high risk of PTEWhat does smoke on an echo signify?TrueTrue or false: the larger the LA, the higher the risk of ATE40%What percentage of cats have LVOTO with HCM?Systolic anterior motion of the mitral valve, LVOTOWhat are some other findings on echo that may occur with HCM?Positive inotrope, increases vigour, worsen obstructionWhy shouldn't you give a cat with SAM and LVOTO pimobendan?Mitral inflow, tissue dopplerWhat functions of echo allow us to determine diastolic dysfunction?DopplerWhat is the preferred technique for taking BP in cats?<90mmHg systolicWhat BP is hypotension in cats?3 readings over 160-180What BP is hypertension in cats?Chem profile, T4, NT proBNPWhat lab tests should be used when diagnosing HCM?Azotemia, increased liver enzymes, electrolytesWhat are the changes expected on a chem profile in HCM?>6 yearsWhat age cats should you evaluate T4 in while trying to diagnose HCM?50-100What is the level of NT proBNP over which is consistent with heart disease?>265What is the level of NT proBNP over which CHF Is very likely?False (it can be used, tend to be elevated in most cats with the disease regardless of symptoms)True or false: NT proBNP can NOT be used to identify HCM in asymptomatic catsTest for occult HCM, monitor worsening, CHFWhat are some uses of NT proBNP in HCM?Murmur, gallop, arrhythmiaWhat signs in cats asymptomatic for HCM should you considering doing an NT proBNP test in?Chance of major heart diseaseIf a cat presents with a murmur or gallop, what does an NT proBNP over 50-100 mean?Over 256pmol/LIf a cat presents with respiratory signs and you need to differentiate between heart and lung origin, what level NT proBNP means it is likely heart disease?Beta blockers, Ca channel blockersWhat drugs are used in HCM to slow HR and improve diastolic function?Atenolol, carvedilolWhat are some examples of beta blockers used in HCM?Diltiazem, cardizem, dilacorWhat are some examples of Ca channel blockers used to treat HCM?False (used when animal is asymptomatic, can worsen CHF once onset occurs)True or false: beta blockers are indicated in cats with HCM once they develop CHFCHF, ATE, syncope, symptomaticWhat are some examples of clinical scenarios that may occur with HCM?Furosemide, ACE inhibitor, pimo if no LVOTO, antithromboticWhat are some ways we can manage CHF in cats?Contraindicated if LVOTO is presentWhy shouldn't use prescribe every cat with heart disease pimobendan like in dogs?10-40$What percentage of cats with HCM develop ATE?LA, sometimes LVWhere does the thrombus originate in ATE in most cases?Rear limbs major site, front limbsWhat are the most common sites for ATE to embolus?False (most commonly in hind or front limbs, but can also be in kidneys, GI, brain, heart, lungs)True or false: ATE can really only get lodged in the hind or front limbsLAaWhat area of the LA do clots tend to originate?Supportive care, antithrombotics, thrombolytics, surgical or catheter thrombolectomyWhat are some ways we can treat an active ATE?ClopidogrelWhat is the most common drug used to prevent ATE?Aspirin, LMWH, rivaroxaban, warfarinWhat are some other drugs beside clopidogrel that can be used to prevent ATE?Slow HR, alleviate obstruction, stop SAM, alter diastolic doppler indices, alter progression of diseaseWhat is the goal of treatment of HCM in an asymptomatic cat?Live 3-5 yearsWhat is the prognosis of cats with HCM is they are asymptomatic?Presenting signsWhat is the prognosis of HCM linked to?LA size, age, SAM, LV hypertrophy, fractional shorteningWhat are some factors that influence the prognosis of HCM?Dramatic fibrosis of LV endocardium, myocardial inflammation beneath, fibrosis restricts diastolic filling, LAE, prone to ATEWhat occurs in restrictive cardiomyopathy?FibrosisWhat is the red arrow pointing to?ThrombusWhat is the yellow arrow pointing to?Non dilated LV, sometimes small, mild or no LV hypertrophy, systolic function ok, dilated LA, mottled LV myocardiumWhat are the characteristics of the myocardial form of restrictive cardiomyopathy?Thinning of RV free wall with RV dilation, myocardium replaced with fat or fibrous tissue, RCHF, arrhythmias, possible LV affected as wellWhat are the characteristics of ARVCM?Tricuspid dysplasiaWhat can ARVCM sometimes be confused with?Nonspecific CMWhat type of cardiomyopathy does not fulfill the criteria of DCM, HCM, RCM, or ARVCM?Variable wall thickness, cavity may be dilated, possible reduced systolic function, mild valvular regurgWhat are some features of nonspecific CM?Burnt out HCMWhat is a possible cause of nonspecific CM?Moderator bandsWhat is the term for abnormal chordae tendinae in various forms of CM?Possible restriction of cardiac fillingWhat is thought to be the role of moderator bands in HCM?Moderator bands (abnormal chordae tendonae)What is the characteristic of this heart?Same as HCMWhat lab tests are used in nonspecific CM?Furosemide, ACE inhibitor, additional diuretic, antiarrhythmic betablocker, pimo sometimes, Na restrictionWhat are some medications we can use to manage CHF in cats?