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Flashcards in Cardio - DCM Deck (52)
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1

What is the structural component of DCM?

Primary myocardial disease, defect in cytoskeleton or metabolism

2

How does DCM affect general heart function?

Decreased LV systolic function (decreased contractility)

LV dilation

Ventricular arrhythmias

3

What is the cause for primary DCM?

Genetic, idiopathic

4

What breed gets primary DCM?

Dobermans

5

What are secondary causes of DCM?

Nutritional deficiencies (taurine/carnitine), infectious/inflammatory, tachycardia-induced, sepsis-induced myocardial dysfunction, doxorubicin cardiotoxicity

6

What do DCM hearts look like?

Attenuated (shrinking) wavy myofibers, myocardial fibrosis and fatty replacement, myocyte atrophy/degeneration/necrosis

7

What is the most common arrhythmia seen with DCM? When do they occur in relation to changes seen on echo?

ventricular arrhythmias;

OFTEN precede echo changes (esp. Dobermans)

8

What other arrhythmia can happen with DCM? When does this happen in relation to changes seen on echo?

atrial fibrillation (due to large atrium);

OFTEN precedes echo changes (esp. in Irish Wolfhounds) and is common in advanced DCM/CHF in all breeds

9

What is the average age that DCM occurs?

6 years

10

How prevalent is DCM in Dobermans?

50% of them have it >6 years

11

What historically causes DCM in cats?

taurine deficiency

12

What sex gets DCM more often?

Males > females

13

What are 3 ways by which DCM can be detected?

Breeder screening, veterinarian screening, Dx following a complication

14

What 3 things can be used in a breeder screening to detect DCM?

Echo/holter monitor, cardiac biomarkers (NT-proBNP, cTnI), genetic testing

15

How is DCM diagnosed on echo?

Decreased LV systolic function (FS%, EF%), increased LV size 

16

What is the gold standard for diagnosis of ventricular arrhythmias?

Holter (>50 VPCs/24 hours)

17

How can ventricular arrhythmias be diagnosed with ECG?

1+ VPCs/5 min

18

Severity of ventricular arrhythmias is correlated with severity of _____ _____.

myocardial dysfunction

19

Other than ventricular arrhythmias, what else can ECGs/Holter monitors detect when DCM is suspected?

A-Fib

20

What are the 2 biomarkers for DCM?

NT-proBNP and cTnI

21

What does increased NT-proBNP mean and what is the cutoff?

myocardial stretch; >450 pmol/L

22

What does increased cTnI mean and what is the cutoff?

myocardial damage; >0.22 ng/ml

23

How can nutritional deficiency be ruled out as a secondary cause of DCM?

consider diet history and supplement taurine if low

24

How can infection/inflammation be ruled out as a secondary cause of DCM?

Consider history and test for infectious diseases such as Trypanosoma, Toxo/Neospora, Bartonella, Borrelia, Ehrlichia, Lepto

25

How can tachycardia-induced myopathy be ruled out as a secondary cause of DCM?

Treat tacharrhythmia and recheck

26

How can sepsis-induced myocardial dysfunction be ruled out as a secondary cause of DCM?

treat sepsis and recheck

27

How can Doxorubicin cardiotoxicity be ruled out as a secondary cause of DCM?

Consider history

28

What are CS associated with DCM?

Signs of CHF: dyspnea/tachypnea, cough exercise intolerance/inappetence/ADR, abdominal distention

29

____ breed dogs hide CHF better than _____ breed dogs

large, small

30

Other than signs of CHF, what 2 things can happen in DCM?

Syncope, sudden cardiac death (arrhythmic)

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