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Avaliação ecocardiográfica e auscultação electrónica de 27 casos de gatos por presença de sopro à auscultação cardíaca convencional
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Resumo(s)
Contexto: ao longo dos anos, as doenças cardíacas do paciente felino têm recebido menos
atenção do que as doenças cardíacas em cães pela classe médico-veterinária (Fuentes,
2015). Numa avaliação comparativa sobre o tema, o Journal of Veterinary Cardiology conteve
cerca de quatro vezes mais estudos relacionados com cães do que com gatos durante os
últimos dez anos (Fuentes, 2015). Para além disso, a presença de sopro à auscultação num
cão é um indicador de doença cardíaca muito mais fidedigno do que um sopro ouvido num
gato (Wagner, Fuentes, Payne, McDermott & Brodbelt, 2010), o que dificulta ainda mais a
interpretação deste som que, muitas vezes, é dinâmico (Dirven, Cornelissen, Barendse, Van
Mook & Sterenborg, 2010).
Objectivos [principais (P) e secundários (S)] deste estudo:
Ρ Compreender a prevalência das doenças cardíacas numa população representativa
de gatos que se apresentaram à consulta com sopro à auscultação;
Ρ Aferir qualitativamente a relevância clínica do uso do estetoscópio electrónico quando
comparado com o método convencional;
Ρ Tentativa de compreender a presença de sopro cardíaco em gatos cujos exames
ecocardiográficos não fundamentam a presença de sopro;
S Calcular a sensibilidade e especificidade da auscultação cardíaca em gatos;
S Tentar compreender a ausência de sopro cardíaco em gatos cujos exames
ecocardiográficos fundamentam a presença de sopro;
S Sensibilizar a classe médico-veterinária para a importância de uma auscultação
detalhada no paciente felino.
Principais conclusões e relevância clínica: cerca de 70% (n=20) dos 27 gatos com sopro
cardíaco apresentaram algum tipo de hipertrofia do ventrículo esquerdo (SIVd ≥ 0,50cm),
destes, 50% (n=10) possuíam concomitantemente algum grau de regurgitação valvular, sendo
a regurgitação mitral a mais prevalente. Apenas um gato se apresentou com sopro (II/VI) e
sem achados ecocardiográficos significativos, podendo este dever-se à sedação administrada,
a alterações hemodinâmicas (anemia, estados infecciosos) ou outras alterações sistémicas.
Dos 27 gatos, houve apenas dois casos (7%) de cardiomiopatia restritiva e um caso (4%) de
cardiomiopatia dilatada. Sete porcento (n=2) apresentou doença cardíaca congénita.
O uso do estetoscópio electrónico provou-se indispensável, principalmente, na detecção de
ruídos de galope e na análise morfológica das ondas e seu relacionamento com a doença
cardíaca presente; na classificação da intensidade de sopros, contudo, mostrou-se ineficiente.
ABSTRACT - Echocardiographic assessment and electronic auscultation of 27 cases of cats by presence of heart murmur on conventional cardiac auscultation - Background: throughout the years, feline heart diseases have received less attention than dog’s heart disease by the veterinary professionals (Fuentes, 2015). In one comparative assessment regarding the subject, the ‘Journal of Veterinary Cardiology’ has about four times more research related to dogs than cats during the last ten years (Fuentes, 2015). Besides, a murmur auscultated on a dog is a much more reliable marker of heart disease than the same sound heard on a cat (Wagner, Fuentes, Payne, McDermott & Brodbelt, 2010), what makes the interpretation of murmurs, sometimes dynamic, much harder (Dirven, Cornelissen, Barendse, Van Mook & Sterenborg, 2010). Objectives [prime (P) and secondary (S)]: Ρ Comprehension of the prevalence of cardiac diseases on a population of cats that were present with heart murmur at auscultation; Ρ Understanding the clinical relevance of the use of electronic stethoscopes compared with the conventional method; Ρ Explanation for the presence of heart murmur in cats which have no significant alteration on echocardiographic examination; S Sensitivity and sensibility calculation for cats’ auscultation; S Explanation for the absence of heart murmurs in cats with alterations on echocardiographic examination; S Sensitize veterinary professionals for the importance of a thorough auscultation of the feline patient. Leading conclusions and clinical significance: about 70% (n=20) of the 27 cats presented with a heart murmur showed some kind of hypertrophy of the left ventricle (SIVd ≥ 0,50cm), half of which (n=10) had some degree of valvular regurgitation at the same time, being mitral regurgitation the most common. Only 1 cat was present with a murmur (II/VI) and no significant echocardiographic findings, probably due to the tranquilization that was administered, hemodynamic alterations (anaemia, infectious states, stress) or other systemic disorders. Of the 27 cats, there were only two cases (7%) of restrictive cardiomyopathy and one case (4%) of dilated cardiomyopathy. Seven percent (n=2) were present with a congenital heart disease. The use of an electronic stethoscope proved itself useful, mainly at the detection of gallop sounds and analysis of wave morphologies and its connection with each cardiac disease; for the classification of the intensity of the murmur, however, it proved itself inefficient.
ABSTRACT - Echocardiographic assessment and electronic auscultation of 27 cases of cats by presence of heart murmur on conventional cardiac auscultation - Background: throughout the years, feline heart diseases have received less attention than dog’s heart disease by the veterinary professionals (Fuentes, 2015). In one comparative assessment regarding the subject, the ‘Journal of Veterinary Cardiology’ has about four times more research related to dogs than cats during the last ten years (Fuentes, 2015). Besides, a murmur auscultated on a dog is a much more reliable marker of heart disease than the same sound heard on a cat (Wagner, Fuentes, Payne, McDermott & Brodbelt, 2010), what makes the interpretation of murmurs, sometimes dynamic, much harder (Dirven, Cornelissen, Barendse, Van Mook & Sterenborg, 2010). Objectives [prime (P) and secondary (S)]: Ρ Comprehension of the prevalence of cardiac diseases on a population of cats that were present with heart murmur at auscultation; Ρ Understanding the clinical relevance of the use of electronic stethoscopes compared with the conventional method; Ρ Explanation for the presence of heart murmur in cats which have no significant alteration on echocardiographic examination; S Sensitivity and sensibility calculation for cats’ auscultation; S Explanation for the absence of heart murmurs in cats with alterations on echocardiographic examination; S Sensitize veterinary professionals for the importance of a thorough auscultation of the feline patient. Leading conclusions and clinical significance: about 70% (n=20) of the 27 cats presented with a heart murmur showed some kind of hypertrophy of the left ventricle (SIVd ≥ 0,50cm), half of which (n=10) had some degree of valvular regurgitation at the same time, being mitral regurgitation the most common. Only 1 cat was present with a murmur (II/VI) and no significant echocardiographic findings, probably due to the tranquilization that was administered, hemodynamic alterations (anaemia, infectious states, stress) or other systemic disorders. Of the 27 cats, there were only two cases (7%) of restrictive cardiomyopathy and one case (4%) of dilated cardiomyopathy. Seven percent (n=2) were present with a congenital heart disease. The use of an electronic stethoscope proved itself useful, mainly at the detection of gallop sounds and analysis of wave morphologies and its connection with each cardiac disease; for the classification of the intensity of the murmur, however, it proved itself inefficient.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Gato sopro cardiomiopatia felina ecocardiografia estetoscópio electrónico Cat murmur feline cardiomyopathy echocardiography electronic stethoscope
Contexto Educativo
Citação
Gomes, A.R.A. (2017). Avaliação ecocardiográfica e auscultação electrónica de 27 casos de gatos por presença de sopro à auscultação cardíaca convencional. Dissertação de mestrado. Universidade de Lisboa, Faculdade de Medicina Veterinária, Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária