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How I Treat...Feline Hypertrophic Cardiomyopathy, With or Without Congestive Heart Failure
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Myocardial diseases in the cat, either idiopathic or genetic origin, are called primary cardiomyopathies. Within these, hypertrophic cardiomyopathy is the most common, but dilated, restrictive, right arrhythmogenic and unclassified are also included. Hypertrophic cardiomyopathy is linked to several breeds such as Persian, Maine Coon, Norwegian Forest and Ragdoll, and several mutations have been identified including myosin binding protein C. The pathophysiological trigger is a thickening of the septum, the free wall and the left ventricular papillary muscles unrelated to a congenital disease, hypertension or previous endocrinopathy. The way in which thickening occurs is highly variable, from concentric, affecting the entire ventricle, to focal. There is some correlation between the location of the hypertrophy and progression of the pathology. So, the free wall thickening usually ends up with severe dysfunction and left atrial dilatation. However, isolated focal thickening in the subaortic area, septum or papillary muscles, usually have a better prognosis. A subaortic focal thickening with subsequent aortic dilatation that progresses with no associated clinical signs is commonly found in cats more than 8-10 years old. The origin of this lesion is uncertain and a genetic conditioning or ectasia of the aortic annulus with subsequent dilatation is hypothesized. […]
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