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Heartworms and Heart Murmurs

Heartworms and Heart Murmurs. An introduction to problems that can occur in the heart. Partnership for Environmental Education and Rural Health Texas A&M University http://peer.tamu.edu. The Heart. Basic Anatomy. Arteries – Carry blood away from the heart Veins – Carry blood to the heart

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Heartworms and Heart Murmurs

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  1. Heartworms and Heart Murmurs An introduction to problems that can occur in the heart Partnership for Environmental Education and Rural Health Texas A&M University http://peer.tamu.edu

  2. The Heart

  3. Basic Anatomy • Arteries – Carry blood away from the heart • Veins – Carry blood to the heart • Capillaries – Site of gas exchange

  4. The Heart as a Pump • The heart works as a pump, forcing blood forward into the arteries. • Blood returns to the heart in veins. Veins have valves. • Valves work to keep the blood from flowing backwards, even when the heart isn’t contracting.

  5. Blood Flow

  6. Heartworms

  7. What are they? • Parasitic worms that live in the heart and blood vessels of animals. • Heartworms (Dirofilaria immitis) affect dogs, coyotes, sea lions, ferrets and cats. • They are transmitted by mosquitoes

  8. Life Cycle of a Heartworm Microfilaria develop into larva (L3) in the mosquito Microfilaria are transmitted to a new mosquito when it bites the infected dog Larvae are transmitted to the dog when the mosquito takes a blood meal Larvae continue to mature in the dog until they become adults Adult heartworms live in the heart and mate to produce microfilaria Microfilaria are released into the bloodstream

  9. Microfilaria Seen at 400x magnification

  10. Adult Heartworms

  11. Clinical Signs • Coughing • Exercise intolerance • Syncope (Fainting) • Ascites (Fluid in the belly)

  12. Radiographs of Heartworm Disease Enlarged Right Atrium Widened Caudal Vena Cava (Caval Syndrome) Enlarged Pulmonary Arteries Lung Disease (Heartworm Pneumonitis)

  13. Prevention • Prevention products make sure dogs don’t get heartworms in the first place • Include: Heartgard, Interceptor, Sentinel, Revolution, Filaribits • As long as the animal is medicated every month, it prevents any larvae from maturing and reaching the heart, thus stopping heartworm disease.

  14. Treatment • Treatment products help cure the animal once it already has heartworms • Elimination of heartworms is a two step process • Must get rid of adult worms and larvae separately • Consists of two shots in the muscle of Immiticide and 4 weeks of strict cage rest

  15. Surgical Removal

  16. Heart Murmurs • What is a heart murmur? • A heart murmur is an extra or unusual sound heard during a heartbeat. • There are many kinds of murmurs, some that are insignificant and some that indicate a heart problem is present.

  17. Special type of heart problem Breakdown the words: Patent: to make open Ductus: tube or canal Arterio: relating to an artery Put the words together to see that it means there is an artery that is open (that should be closed!) Patent Ductus Arteriosus

  18. PDA in canines • Most common canine congenital (present at birth) heart problem • Affects 5 out of 1000 dogs, in any size or breed • 65% of dogs with this problem will die by 1 year of age if it is not fixed • Most have the problem diagnosed between 1 month and 3 ½ years of age

  19. PDA in humans • The estimated incidence is from 6 out of every 100,000 live births up to 2 out of every 10,000 live births. • This incidence is increased in children who are born prematurely. • The death rate is very low except in extremely premature infants. • It occurs twice as often in girls as in boys.

  20. Return to Anatomy

  21. Normal versus PDA heart

  22. Symptoms • Can a patient live normally? • Sometimes there are no symptoms • In large PDAs, symptoms can include: • Exercise intolerance • Sweating • Dyspnea (difficulty breathing) • Poor weight gain Audio of a PDA murmur Audio of a normal heart

  23. Management Options • Observation and monitoring • Medical Management • Medications may be prescribed to reduce blood pressure, maintain normal heart rhythm, and prevent fluid overload. • Surgical • Surgical repair • Ligating (suturing closed) the patent artery • Catheter based occlusion • Placing a “coil” inside the artery to stimulate closure

  24. Surgical Ligation Aorta PDA Pulmonary Artery

  25. Catheter Based Occlusion • With a surgery called Transarterial Ductal Occlusion With Coils • Very safe procedure • Very successful procedure (95% need nothing else)

  26. Transarterial Ductal Occlusion Aorta (with catheter inside) PDA Coil within PDA *Notice how no dye is visible in the pulmonary artery anymore! Pulmonary Artery

  27. Any Questions?

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