Description
Hypertrophic cardiomyopathy is one of several forms of heart
muscle disease which commonly affects cats and is rarely diagnosed in dogs.
The disease is characterised by gross thickening of the muscle in the
walls of the heart which makes the walls stiff and less compliant. This
results in poor filling of the heart chambers with blood during the diastolic
phase of contraction, and inadequate output of blood during systole. The
clinical signs of this condition are those of heart failure.
Cause
The cause is unknown.
Breed Occurrence
The condition is rare in dogs but the German Shepherd Dog is cited
as being the breed most likely to present with hypertrophic cardiomyopathy.
In cats no particular breed or group are affected.
Age
Hypertrophic cardiomyopathy can occur at any age in cats (range 5 months-14
years)
Signs
Sudden death without prior warning can occur. Some cases present with
"forward failure" of the heart and exhibit exercise intolerance. Cats are
often off their food (called anorexia) and lethargic with increased respiratory
rate (tachypnoea) difficulty breathing (dyspnoea) and in some cats feinting
and lameness due to thromboembolism).
X-ray
Chest X-rays may not show much heart enlargement, though left-sided
enlargement is often seen. Evidence of fluid in the lung tissue (pulmonary
oedema) tends to be diffuse in cats, and more localised in dogs. Sometimes
free thoracic fluid (pleural effusion) masks the presence of oedema.
Ultrasound (Echocardiography)
Echocardiography clearly shows a small chamber to the left ventricle
with thick muscular walls. Often can detect atrial enlargement and occasionally
see thrombi when they are present. M-mode examination of the left ventricle
also demonstrates the thickened free muscular wall and septum.
Treatment
The same as for the treatment of heart failure.
Prognosis
If the patient has mild to moderate severity of the disease a good
response to treatment can be expected, but dysrhythmias and sudden death
can still occur and in cats which develop thromboembolism the prognosis
is much worse.