Overview
Myxomatous mitral valve disease (MMVD), also known as endocardiosis or chronic valvular heart disease, is a common degenerative condition affecting cardiac valves in dogs 1. It is characterized by myxoid transformation, leading to valve thickening and malformation 1.Diagnosis
Diagnosis is based on physical examination findings, including auscultation of a heart murmur, and echocardiographic evidence of valve thickening and regurgitation 1.
The ACVIM guidelines propose a staging system for MMVD, ranging from Stage A (at risk) to Stage D (advanced heart failure) 1.
Echocardiography is crucial for assessing valve morphology, degree of regurgitation, chamber size, and cardiac function 1.Management
Management strategies vary based on the stage of the disease 1.
For asymptomatic dogs (Stage B1), no specific medical therapy is recommended 1.
For asymptomatic dogs with evidence of cardiac remodeling (Stage B2), treatment with pimobendan is recommended 1.
For dogs with clinical signs of heart failure (Stage C and D), treatment typically involves a combination of diuretics (e.g., furosemide), ACE inhibitors, and pimobendan 1.
Diuretics are used to manage pulmonary edema and ascites 1.
Pulmonary hypertension is a common complication and may require specific management 1.Key Recommendations
Pimobendan is recommended for the management of asymptomatic dogs with myxomatous mitral valve disease and evidence of cardiac remodeling (Stage B2) 1. (Evidence: Strong)
Diuretics, such as furosemide, are a cornerstone of treatment for dogs presenting with clinical signs of heart failure due to MMVD (Stage C/D) 1. (Evidence: Strong)
Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with previous guidelines 1. (Evidence: Strong)References
1 Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL et al.. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of veterinary internal medicine 2019. link