Feline Cardiomyopathies
bringing cardiology into practice...
Insights Into The Feline Heart
Understanding, Diagnosing, and Treating Feline Cardiomyopathy
Whit Church, DVM, Diplomate ACVIM (Cardiology) Desert Veterinary Medical Specialists Gilbert, Scottsdale, and Glendale, AZ
Why are Cat Heart Sounds So Difficult to Characterize? A. Gallop heart sounds can be hard to detect. B. Murmurs in cats all sound the same. C. Cats are small; the valve areas are close
together. D. The position of the heart in the thorax changes
w/age. E. Most feline heart murmurs are dynamic (labile). F. Knowledge deficits about murmur location,
prevalence. G. All of the Above.
bringing cardiology into practice...
Cardiac Auscultation in Cats
The neglected area: ventral thorax directly over the sternum
Cat heart murmurs: ?Virtually always systolic ?Location described as left or right
parasternal
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8/16/19 1
Why are Cat Heart Sounds So Difficult to Characterize?
The position of the heart in the thorax changes w/age.
Young cat
bringing cardiology into practice...
Old cat
Why are Cat Heart Sounds So Difficult to Characterize?
Cats are small; the valve areas are close together.
bringing cardiology into practice...
Common Acquired Heart Diseases of Cats
! Cardiomyopathy
? Hypertrophic (HCM) ? Restrictive (RCM) or Unclassified (UCM) ? Less Common
? Dilated (DCM) ? Arrythmogenic Right Ventricular (ARVC)
! Systemic Hypertension (SH) ! Hyperthyroidism (HT4)
bringing cardiology into practice...
8/16/19 2
Common Acquired Heart Diseases of Cats
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Most Common Primary Myocardial Diseases
Hypertrophic Cardiomyopathy
HCM
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Restrictive Cardiomyopathy
mRCM/eRCM
Left Ventricular Hypertrophy in Cats
Hypertrophic Cardiomyopathy
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Hyperthyroidism Systemic Hypertension
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Pathology of HCM
Myocardial Fibrosis
Myocardial Fiber Disarray
LV Hypertrophy
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The Three Most Common Heart Murmurs of Adult Cats
Dynamic RVOT Obstruction
Normal Ejection
Dynamic LVOT Obstruction
DSAS, SAM, HOCM
Mitral Regurgitation
DSAS, SAM, HOCM
RVOT Obstruction
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LVOT Obstruction
Dynamic LVOT Obstruction ! Systolic anterior motion (SAM) of the mitral valve
Ao
Ao
LA
LA
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Dynamic LVOT Obstruction
Dynamic LVOT obstruction:
?Caused by systolic anterior motion (SAM) of the mitral valve ?Creates a source of pressure overload to the left ventricle
?Pressure overload?concentric hypertrophy in an already hypertrophied HCM heart!
early systole bringing cardiology into practice...
mid systole
late systole
Systolic Anterior Motion of the Mitral Valve
Results in additional Hypertrophy!!!
bringing cardiology into practice...
Dynamic RVOT Obstruction
Normal
DRVOT Obstruction
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Unlike LV obstruction, RV obstruction is relatively benign and does not appear to cause overload to the heart.
8/16/19 5
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