Heart disease, or cardiac disease, can be a devastating clinical condition in companion animals. Early recognition and treatment can facilitate appropriate clinical management and a long life.
“Dirty” blood (carrying carbon dioxide from organs, tissues, and cells) enters the right atrium through large vena cava veins and flows to the right ventricle via the tricuspid valve. It then travels through the pulmonary artery (via the pulmonary valve) to the lungs to collect oxygen and eliminate carbon dioxide and re-enters the left atrium through the pulmonary vein. The mitral valve ferries the oxygen-rich blood to the left ventricle, and the aorta (entering through the aortic valve) carries “clean” oxygen-rich blood to the remainder of the body.
Cardiac disease is classified as either congenital or acquired.
Most congenital cardiac defects are present from birth or near birth and include conditions such as septal defects (atrial and ventricular), valve dysplasias, and congenital cardiomyopathies. All involve some degree of structural heart or valvular dysfunction. Although some breed-associated congenital conditions are detected early in life, others are not identified until adulthood; Maine Coon cats are frequently diagnosed with cardiac disease.
Acquired conditions can also affect any heart component and are not present at or near birth. They develop over time and with age, and many are not pathologic or progressive. However, some may be associated with progressive heart and valve disease.
A heart murmur is an extra sound in the heart beat, which is detected by the veterinarian during the physical examination. Such murmurs usually develop secondary to turbulent blood flow. Heart murmurs are identified in patients with and without heart disease.
Many murmurs are innocent, particularly those identified in young kittens without any evidence of cardiac disease. They are soft murmurs and usually disappear on their own. Other benign murmurs are seen secondary to anemia (decreased red blood cell count), pain, and intense excitement.
Pathologic murmurs may have very characteristic sounds and locations and are associated with cardiac disease.
Clinical signs and complications of heart disease in cats can include:
Note: Breathing difficulties are an extremely common cardiac complication in cats because of fluid retention inside or outside the lungs.
Feline aortic thromboembolic disease (FATE) results from clot formation in the diseased heart, particularly in cats with hypertrophic cardiomyopathy. The clots travel through the aorta as it descends and may partially or completely obstruct aortic flow. This cuts off rear leg blood supply and causes rear leg paralysis; it can be very painful. Such cats will present to the clinic with weak or absent pulses and paralyzed legs that are ice-cold to the touch. It is a devastating consequence of feline cardiac disease.
Diagnosis is usually facilitated by a combination of cardiac ultrasonography (ultrasound), chest x-rays, blood pressure measurement, blood work/cardiac enzyme level measurement, urinalysis, and electrocardiogram analysis. Veterinary cardiologists may perform more advanced diagnostics in necessary cases.
Treatment is dependent on the causative factor of the heart disease; its goal is to slow the progression of heart failure. Treatment may include any of the following therapies and drugs:
Prognosis is completely dependent on the etiology, or cause, of the heart disease and how advanced it is.
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