okvet [Textbook of Cardiovascular Medicine in Dogs and Cats]

Table of contents

1 CARDIOVASCULAR EMBRYOLOGY AND MORPHOLOGY

Massimiliano Tursi

Cardiovascular embryology

The earliest stages: cardiogenic plate and heart tube formation

Contraction and early development of the vascular system

Heart looping

External morphogenesis of the heart tube

Development of the vascular system

Internal morphogenesis: formation of the atrioventricular, interatrial,

and interventricular septa

Valvulogenesis

Cardiovascular morphology

The heart, external morphology, position, and relationships with the

surrounding organs

The atria

The ventricles

Anatomy of the valves

Anatomy of the coronary arteries and veins

The great vessels

Bibliography

2 CARDIOVASCULAR PHYSIOLOGY AND PATHOPHYSIOLOGY

Claudio Bussadori, Stefano Oricco

The cardiac action potential

Heart rate regulation

Arterial baroreceptor reflex

Bainbridge reflex

Bezold–Jarisch reflex

Nicoladoni–Branham sign

Preload, afterload, and contractility

Preload

Afterload

Contractility

The cardiac cycle

Introduction to P-V loops

Left ventricular systolic and diastolic function

Mechanism of contraction and relaxation

Rotation, twist, and torsion

Physiological and pathophysiological variables

The helical ventricular myocardial band

Left atrial function

The right ventricle

The arterial and venous systems

The arterial system

The venous system

Ventriculo-arterial coupling

Cardiac remodeling in heart diseases and heart failure

Myocardial hypertrophy

Neurohumoral activation

Inflammatory response

Bibliography

Congenital Cardiovascular Diseases

3 CONGENITAL HEART DISEASES: GENETICS, EPIDEMIOLOGY, AND CLINICAL APPROACH

Claudio Bussadori, María Josefa Fernández del Palacio, Paola Giuseppina

Brambilla

Genetics of congenital heart diseases

Epidemiology of CHDs

Authors’ data

Epidemiology of CHDs in cats

Clinical approach of patients with congenital heart diseases

Patient’s history, clinical signs and physical examination

Thoracic radiography

Electrocardiography

Laboratory tests and cardiac biomarkers

Echocardiography

Cardiac catheterization and angiography

Computed tomography and cardiac magnetic resonance imaging

Bibliography

4 CONGENITAL DISEASES OF THE RIGHT HEART

Claudio Bussadori

Introduction

Pulmonic stenosis

Pathology

Pathophysiology and natural history

Epidemiology

Clinical signs and physical examination findings

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Association with other congenital heart diseases

Treatment

Indications and preprocedural evaluation

Postoperative evaluation

Medical therapy

Pulmonic stenosis in cats

Pulmonary artery stenosis

Double-chambered right ventricle

Etiology

Treatment

Tricuspid dysplasia

Epidemiology

Pathology

Pathophysiology and natural history

History and clinical examination

Electrocardiography

Radiography

Echocardiography

Treatment

Persistence of the right valve of the sinus venosus

Diagnosis

Treatment

Bibliography

5 CONGENITAL DISEASES OF THE LEFT HEART

Claudio Bussadori

Introduction

Malformations of the aortic valve apparatus

Pathology

Pathophysiology and natural history

Signalment

History and clinical examination

Electrocardiography

Radiography

Echocardiography

Association with other CHDs

Breed screening

Treatment

Mitral valve dysplasia

Pathology

Pathophysiology

Clinical examination

Electrocardiography

Radiography

Echocardiography

Treatment

Supravalvular obstruction of the mitral valve

Diagnosis

Treatment

Bibliography

6 CONGENITAL CARDIOVASCULAR DISEASES WITH A SYSTEMIC-TO-PULMONARY SHUNT

Claudio Bussadori

Patent ductus arteriosus

Pathology and pathophysiology

Association with other CHDs

Signalment

History and clinical examination

Electrocardiography

Radiography

Echocardiography

Treatment

PDA in cats

Other systemic-to-pulmonary vascular shunts

Atrial septal defects

Introduction

Anatomy and pathophysiology

ASD pathology and pathophysiology

History and clinical examination

Electrocardiography

Radiography

Echocardiography

Natural history and treatment

Patent foramen ovale

Atrioventricular septal defects

Pathophysiology and natural history

History and clinical examination

Echocardiography

Treatment

Double-outlet right atrium (DORA)

Pathophysiology and natural history

Epidemiology, history, and clinical signs

Treatment

Ventricular septal defects

Anatomy

Pathophysiology

Clinical examination

Electrocardiography

Radiography

Echocardiography

Treatment

Tetralogy of Fallot

Anatomy

Pathophysiology

Clinical examination

Electrocardiography and radiography

Echocardiography

Medical and surgical management

Bibliography

7 UNCOMMON CONGENITAL HEART DEFECTS

María Josefa Fernández del Palacio, Diego Lessa, Claudio Bussadori

Conotruncal septal defects

Persistent truncus arteriosus

Abnormalities and pathophysiology

Clinical findings and diagnosis

Treatment and prognosis

Transposition of the great arteries

Abnormalities and pathophysiology

Clinical findings and diagnosis

Treatment and prognosis

Aortopulmonary window

Abnormalities and pathophysiology

Clinical findings and diagnosis

Treatment and prognosis

Congenital endocardial fibroelastosis

Lesions and pathophysiology

Clinical signs and diagnosis

Treatment

Prognosis

Anomalous origin of the left coronary artery from the pulmonary

artery

Abnormalities and pathophysiology

Clinical findings and diagnosis

Electrocardiography

Radiography

Echocardiography

Treatment and prognosis

Pulmonary atresia with intact interventricular septum

Abnormalities and pathophysiology

Clinical examination and diagnosis

Electrocardiography

Radiography

Echocardiography

Treatment and prognosis

Uhl’s anomaly

Abnormalities and pathophysiology

Clinical findings and diagnosis

Electrocardiography

Radiography

Echocardiography

Situs inversus totalis

Clinical examination

Electrocardiography

Radiography

Echocardiography

Treatment and prognosis

Vascular ring anomalies

Clinical findings and diagnosis

Treatment and prognosis

Bibliography

* For congenital pericardial diseases, see Chapter 12.

Acquired Cardiovascular Diseases

8 MYXOMATOUS VALVULAR DISEASE

Ingrid Ljungvall, Jens Häggström

Introduction

Epidemiology, etiology, and pathogenesis

Epidemiology

Etiology

Pathogenesis

Pathology and pathophysiology

Pathology

Pathophysiology

Clinical signs

Physical examination

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Laboratory tests

Classification of severity

Management

Preclinical dogs (ACVIM stage B)

Mild to moderate signs of congestive heart failure (ACVIM stage C)

Recurrent signs of congestive heart failure (ACVIM stages C or D)

Severe and life-threatening (fulminant) congestive heart failure

(ACVIM stages C or D)

Management of complications associated with myxomatous mitral

valve disease

Coughing

Pulmonary hypertension

Arrhythmia leading to syncopal events

Acute rupture of the chordae tendineae

Left atrial rupture and cardiac tamponade

Bibliography

APPENDIX 8A: TRANSCATHETER EDGE-TOEDGE

MITRAL VALVE REPAIR

E. Christopher Orton, Brianna Potter, Claudio Bussadori

Case selection for mitral intervention

Procedure description

Expected outcomes

Bibliography

9 INFECTIVE ENDOCARDITIS

Ingrid Ljungvall, Jens Häggström

Introduction

Epidemiology and pathogenesis

Epidemiology

Etiology

Pathogenesis

Pathophysiology and clinical signs

Pathophysiology

Clinical signs

Physical examination

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Laboratory tests

Diagnostic criteria

Management

Prognosis

Prevention

Bibliography

10 CANINE CARDIOMYOPATHIES

Alessandra Franchini, Michele Borgarelli

Introduction

Canine dilated cardiomyopathy

Epidemiology and etiology

Pathology and pathophysiology

Clinical signs and physical examination findings

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Laboratory tests

Management and therapy

Diuretics

Positive inotropic drugs

β-blockers

ACE inhibitors

Antiarrhythmic treatment

Prognosis

Arrhythmogenic right ventricular cardiomyopathy

Epidemiology and etiology

Pathology and pathophysiology

Clinical signs and physical examination findings

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Laboratory tests

Management and therapy

Antiarrhythmic treatment

Prognosis

Arrhythmia-induced cardiomyopathy

Epidemiology and etiology

Pathology and pathophysiology

Clinical signs and physical examination findings

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Management and therapy

Prognosis

Doxorubicin-induced cardiomyopathy

Epidemiology and etiology

Pathology and pathophysiology

Clinical signs and physical examination findings

Diagnostic methods

Electrocardiography

Echocardiography

Management and therapy

Nutritional cardiomyopathy

Taurine

L-carnitine

Grain-free diets

Myocarditis

Hypertrophic cardiomyopathy

Bibliography

11 FELINE CARDIOMYOPATHIES

María Josefa Fernández del Palacio

Introduction

Hypertrophic cardiomyopathy

Etiology

Pathology and pathophysiology

Epidemiology, clinical signs, and physical examination findings

Diagnosis

Electrocardiography

Thoracic radiography

Echocardiography

Magnetic resonance imaging

Laboratory tests

Classification of severity

Management and therapy

Stage A

Stage B

Stage C

Stage D

Treatment of arterial thromboembolism

Prognosis

Screening programs

Restrictive cardiomyopathy

Etiology

Pathology and pathophysiology

Epidemiology, clinical signs, and physical examination findings

Diagnosis

Management and therapy

Prognosis

Dilated cardiomyopathy

Etiology

Pathology and pathophysiology

Epidemiology, clinical signs, and physical examination findings

Diagnosis

Management and therapy

Prognosis

Monitoring

Arrhythmogenic cardiomyopathy

Etiology

Pathology and pathophysiology

Epidemiology, clinical signs, and physical examination findings

Diagnosis

Treatment

Monitoring

Nonspecific cardiomyopathies

Myocarditis

Bibliography

12 PERICARDIAL DISEASES

María Josefa Fernández del Palacio

Introduction

Anatomy and physiology of the pericardium

Congenital pericardial diseases

Peritoneopericardial diaphragmatic hernia

Epidemiology

Clinical signs and physical examination

Diagnosis

Treatment

Intrapericardial cysts

Clinical signs and diagnosis

Treatment

Pericardial defects

Etiology, lesions, and pathophysiology

Clinical signs

Diagnosis

Treatment and prognosis

Acquired pericardial diseases

Pericardial effusion/cardiac tamponade

Etiology

Pathophysiology

Epidemiology, clinical findings, and physical examination

Nonimaging diagnostics

Imaging diagnostics

Therapy for pericardial effusion and cardiac tamponade

Prognosis

Constrictive pericardial disease

Etiology and pathophysiology

History, clinical findings, and physical examination

Diagnosis

Therapy

Pericardial mesothelioma

Etiology, lesions, and pathophysiology

Clinical evaluation and diagnosis

Treatment and prognosis

Bibliography

13 CARDIAC TUMORS

Claudio Bussadori

Introduction

Epidemiology and pathogenesis of cardiac tumors

Author’s data

Phenotypes of cardiac tumors

Hemangiosarcoma

Heart base tumors

Chemodectoma

Ectopic thyroid tumor

Lymphoma

Mesothelioma

Less common cardiac tumors

Metastatic cardiac tumors

Pathophysiology and clinical signs

Cardiac tamponade

Compression

Obstruction

Infiltration

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Other diagnostic procedures

Prognosis and treatment

Pericardiocentesis

Pericardectomy and pericardiotomy

Vascular stenting

Surgery

Chemotherapy

Bibliography

14 PULMONARY HYPERTENSION

Claudio Bussadori

Introduction

Epidemiology and etiology of pulmonary hypertension

Physiology and pathophysiology

Pulmonary circulation

Pathophysiology of pulmonary vasoconstriction

Vascular anatomical remodeling

Cardiac remodeling

Different phenotypes of pulmonary hypertension

Type 1: Pulmonary arterial hypertension

Type 2: Pulmonary hypertension due to left heart disease

Type 3: Pulmonary hypertension due to respiratory diseases and

hypoxia

Type 4: Pulmonary hypertension due to thrombotic and/or embolic

disease

Diagnostic methods

Electrocardiography

Radiography

Echocardiography

Right heart catheterization

Management and therapy

Oxygen supplementation

Diuretics

Positive inotropic drugs

Pulmonary vasodilators

Bibliography

15 CARDIAC EFFECTS OF SYSTEMIC DISEASES AND METABOLIC DISORDERS

Stefanie M. DeMonaco

Introduction

Endocrine disorders

Feline hyperthyroidism

Canine hyperthyroidism

Hypothyroidism

Hypersomatotropism (acromegaly) in cats

Hyperadrenocorticism in dogs

Pheochromocytoma

Primary hyperaldosteronism in cats

Hypoadrenocorticism in dogs

Electrolyte disorders

Potassium disorders

Calcium disorders

Magnesium disorders

Anemia

Nutritional deficiencies

Taurine deficiency

Carnitine deficiencies

Deficiencies in B vitamins

Grain-free diets

Renal disorders (uremia)

Infectious diseases

Bacterial diseases

General considerations

Borreliosis

Protozoal diseases

Chagas’ disease

Leishmaniasis

Fungal diseases

Coccidioidomycosis

Blastomycosis

Viral diseases

Parvovirus

Feline infectious peritonitis

Systemic hypertension

Thromboembolic disorders

Parasitic diseases

Heartworm

Angiostrongyliasis

Miscellaneous

Systemic inflammatory response syndrome

Splenectomy

Systemic lupus erythematosus

Bibliography

Author

Claudio Bussadori

MD, DVM, cardiologist, PhD, Dipl. ECVIM (Cardiology)

Clinica Veterinaria Gran Sasso, Milano (Italy)