Canine Myxomatous Mitral Valve Disease

Book Introduction iii
Preface v
About the Author vii

CHAPTER 01 | Basic Structure and Function of the Cardiovascular System 1
1.1 Basic Anatomy of the Cardiovascular System 1
Pericardium 1
Lungs 1
Heart 2
Cardiac Blood Vessels 8
Cardiac Conduction System 9
1.2 Function of the Cardiovascular System 11
Cardiovascular Circulation 11
Cardiac Cycle 14
Cardiac Contraction and Relaxation 16
Cardiovascular Regulation 18
Cardiac Conduction Pathway 22

CHAPTER 02 | Therapeutic Strategies and Medications for Heart Failure in Small Animals 27
2.1 Medications Used in Heart Failure 28
Diuretics 28
RAAS Blockers (Renin-Angiotensin-Aldosterone System Blockers) 32
Vasodilators 34
Inotropes 39
Beta-Blockers 43
Antiarrhythmics 44
Anticoagulants/Thrombolytics 46
2.2 Nutritional Therapy for Heart Disease 46
Sodium Restriction 47
Protein 48
Potassium 49
Vitamins 49
Antioxidants 50
2.3 Treatment Strategies for Heart Failure (American College of Veterinary Internal Medicine Guidelines) 50
Strength of Recommendation 53
Strength of Evidence 54
Diagnosis and Treatment Guidelines 54
Problems with the ACVIM Guidelines 63

CHAPTER 03 || Myxomatous mitral valve disease 67
3.1 Introduction 67
3.2 Pathogenesis 69
3.3 Clinical Findings 70
3.4 Diagnosis 73
3.5 Treatment and Prognosis 79
3.6 Complications that Worsen the Progression of Heart Valve Disease 80
3.7 Systemic Complications Due to Heart Valve Disease 83
Cardiorenal Syndrome (CRS) 83
Pancreatitis 86
3.8 Echocardiographic Diagnostic Guidelines for Mitral Valve Insufficiency Patients 87
3.9 Diagnostic guideline for determining the severity of mitral valve disease 105

CHAPTER 04 || Case Studies 111
▶CASE 1 111
Patient Information 111
History and Physical Examination 111
Diagnostic Tests 111
Treatment and Patient Monitoring 116
Case Discussion 117
▶CASE 2 121
Patient Information 121
Physical Examination and Phonocardiogram 121
Diagnostic Tests 121
Treatment and Patient Monitoring 126
Case Discussion 126
▶CASE 3 130
Patient Information 130
Physical Examination 130
Diagnostic Tests 130
Treatment and Patient Monitoring 131
Case Discussion 135
▶CASE 4 139
Patient Information 139
Physical Examination 139
Diagnostic Tests 139
Treatment and Patient Observation 142
Case Discussion 146
▶CASE 5 149
Patient Information 149
Physical Examination and Phonocardiography 149
Diagnostic Tests 149
Treatment and Patient Observation 151
Case Discussion 153
▶CASE 6 Mitral Regurgitation - Transcatheter Edge-to-Edge Mitral Valve Repair (TEER) with V-clamp 155
Patient Information 155
Treatment and Patient Monitoring 157
Discussion 159

CHAPTER 05 || New Medical and Surgical Therapeutics 163
5.1 New Medical Therapeutics and Approaches 163
New Medications and New Findings 163
5.2 Drug Trials 171
5.3 New Surgical Therapeutics and Approaches 174
New Cardiac Interventions 174
New Hybrid Therapies 180
New Surgical Therapies 183

Appendix
Imaging Diagnosis Guidelines for Myxomatous Mitral Valve Disease 187
Chest Radiographic Indicators 187
Key Echocardiographic Indicators Used by the Author 190

Index 199