ISSN 2398-2950      

Pericardial disease

ffelis

Synonym(s): Pericardial effusion, constrictive pericarditis


Introduction

  • Sporadic in the cat. Effusion or inflammation within the pericardium or congenital pericardioperitoneal diaphragmatic hernia (PPDH) relatively common.
  • Cause: neoplasia, bacterial infection, renal failure, coagulopathies, congenital pericardioperitoneal, diaphragmatic hernia, trauma.
  • Signs: usually insignificant amount of fluid, but can produce cardiac tamponade and right heart failure.
  • Diagnosis: clinical signs, radiography, electrocardiography, ultrasonography, pericardiocentesis.
  • Treatment: depends on identification of cause.
  • Prognosis: poor with neoplasia, guarded with pericarditis.

Pathogenesis

Etiology

Pathophysiology

  • Pericardial disease   →   restricts ventricular dilation and impedes atrial and ventricular filling (particular right side)   →   right side more susceptible (thinner walled; lower pressure system)   →   decreased end-diastolic volumes   →   poor cardiac output (by the Frank-Starling mechanism)   →   sympathetic nervous system and renin-angiotensin-aldosterone system activated   →   tachycardia, vasoconstriction, retention of sodium and water   →   increased end-diastolic pressures in atria   →   increased ventricular filling pressures   →   backward heart failure   →   increased central venous pressure Central venous pressure (distended jugular veins, hepatic venous congestion, ascites).

Timecourse

  • Slow insidious subclinical course with apparent acute onset described by owners.
  • Peracute presentation: may result from hemorrhage (ruptured neoplasm, trauma, coagulopathy).

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rush J E, Keene B W & Fox P R (1990) Pericardial disease in the cat: a retrospective evaluation of 66 cases. JAAHA 26 (1), 39-46 VetMedResource.

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