DCM

Question 1

Identify the rhythm

Answer 1

Atrial Fibrillation
DCM

Question 2

What are the ECG findings of atrial fibrillation?

Answer 2

No discernable P waves
Chaotic (irregularly irregular) rhythm
Narrow complex/supraventricular tachycardia

Question 3

What physical exam findings increase suspicion of DCM?

Answer 3

Tachycardia
Irregular/chaotic cardiac rhythm
Grade II/VI left apical systolic murmur
Dyspnea

Question 4

What are causes of mitral regurgitation?

Answer 4

Valve problems
* DMVD
* Infective endocarditis
* Mitral valve dysplasia/malformation
Chamber remodeling problem (functional MR)
* DCM

Question 5

What murmur is associated with mitral regurgitation in dogs with DCM?

Answer 5

Left apical systolic
Tend to be quieter - grade 1 or 2

Question 6

What causes secondary DCM?

Answer 6

Nutritionally mediated
Tachycardia-induced
Myocarditis
Cardiotoxicity

Question 7

What are tge 3 radiographic hallmarks of cardiogenic pulmonary edema?

Answer 7

Severe LA and LV enlargement
Pulmonary edema: perihilar and caudodorsal interstitial (+/- alveolar) pattern
Pulmonary venous distension

Question 8

What is the difference between atrial fibrillation and ventricular tachycardia?

Answer 8

V-tach requires urgent therapy (life threatening)
A-fib does not
A-fib + tachycardia usually associated with severe cardiac disease and heart failure

Question 9

Define: Primary DCM

Answer 9

Functional impairment and/or electrical abnormalities in the absence of any other cardiovascular disease to cause the myocardial abnormality
DCM IS SYSTOLIC DYSFUNCTION (PUMP DYSFUNCTION)

Question 10

How is DCM clinically recognized?

Answer 10

Auscultation: LAS murmur (low grade), gallop, arrhythmia
Clinical signs: exercise intolerance, syncope, dyspnea, abdominal distension

Question 11

Acute CHF Treatment

Answer 11

Sedation, Pimobendan, Oxygen, Furosemide
Antiarrhythmics once stabilized (diltiazem +/- digoxin)

Question 12

How is preclinical DCM managed?

Answer 12

Pimobendan +/- ACEi, spironolactone, beta-blockers
Anti-arrythmics as needed (lidocaine, sotalol)
Treat underlying cause if possible
Change the diet if non-traditional

Question 13

How is clinical DCM managed?

Answer 13

Treat CHF if needed
Antiarrhythmics (lidocaine, sotalol)
Treat underlying cause if possible
Change the diet if non-traditional