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Heart-to-heart: practical answers to everyday cardiology questions
Presented by Sonya G. Gordon, BS, DVM, DVSc, Dipl. ACVIM (cardiology)
Continuing education questionnaire
CE credit: 1
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Heart-to-heart: practical answers to everyday cardiology questions
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Questions
1. You are evaluating an 11-year-old, neutered male Yorkie-poo for his annual exam and detect a grade 4/6 left apical systolic murmur. Which of the following statements is correct according to the ACVIM consensus statement guidelines? He has:
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Stage B myxomatous mitral valve disease and an echocardiogram should be recommended
Stage B1 myxomatous mitral valve disease and thoracic radiographs should be recommended
Stage B myxomatous mitral valve disease and pimobendan should be initiated
Stage A myxomatous mitral valve disease and systemic blood pressure evaluation should be recommended
2. You just diagnosed Stage C myxomatous mitral valve disease in an older, small breed dog. Concerning ACVIM guideline-directed chronic treatment recommendations, which of the following treatments are appropriate for this dog?
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Pimobendan, spironolactone, angiotensin converting-enzyme (ACE) inhibitor, furosemide
Pimobendan, furosemide, ACE inhibitor, sotalol
Pimobendan, spironolactone, ACE inhibitor
Pimobendan, ACE inhibitor, diltiazem
3. According to the current ACVIM consensus statement myxomatous mitral valve disease guidelines, the best practice recommendation to establish a diagnosis of Stage B2 is:
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A radiographic vertebral heart size (VHS) ≥10.5
A radiographic vertebral left atrial size (VLAS) >2.3
An echocardiographic left atrium to aortic annulus ratio (LA:Ao) ≥1.6 and a left ventricular internal dimension in diastole normalized for body weight (LVIDdN) ≥1.7
A left apical systolic murmur ≥3/6
4. An asymptomatic 9-year-old Lhasa apso has a left apical systolic murmur characteristic of mitral regurgitation. VHS is 11.7; VLAS is 2.9. Which treatment from the ACVIM myxomatous mitral valve disease consensus statement guidelines is correct?
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Initiate pimobendan
No treatment at this time, recheck radiographs in 6 months
Initiate spironolactone
Initiate ACE inhibitor
5. Which grade of left apical systolic murmur is most likely to be associated with Stage B1 myxomatous mitral valve disease?
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Grade 1–2/out of 6
Grade 3–4 out of 6
Grade 5–6 out of 6
No murmur
6. True of False. Nutrition-associated dilated cardiomyopathy in dogs is often related to taurine deficiency in dogs fed grain-fee diets.
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True
False
7. You perform thoracic radiographs on an asymptomatic 12-year-old, miniature poodle with a grade 2/6 left apical systolic murmur. The VHS is 10.2; the VLAS is 2.1. What is this dog’s MMVD stage?
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Stage B1 chronic valvular disease
Stage B2 chronic valvular disease
Stage C chronic valvular disease
There is not enough information available to stage this dog
8. According to the ACVIM MMVD guidelines, what recommendation should you make regarding treatment for this poodle?
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Initiate enalapril
Initiate pimobendan
Initiate spironolactone
No treatment is indicated
9. True or False. Referral to a cardiologist is always indicated for dogs who require an echocardiogram in order to confirm a diagnosis of MMVD.
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True
False
10. You perform thoracic radiographs on an asymptomatic 6-year-old Chihuahua with a grade 5/6 left apical systolic murmur. The VLAS is 3.3; the VHS is 11.3. What is this dog’s MMVD stage?
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Stage B1 chronic valvular disease
Stage B2 chronic valvular disease
Stage C chronic valvular disease
There is not enough information available to stage this dog
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COMPANION
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