Chapter 13 Cardiovascular Effects of Systemic Diseases
INTRODUCTION
Many systemic diseases are capable of profoundly affecting cardiovascular structure and function (Box 13-1). The veterinarian may detect cardiovascular abnormalities as the predominant clinical sign or systemic disease manifestations may overshadow cardiac abnormalities. Although cardiovascular manifestations may sometimes be of no clinical significance, at other times they may constitute the major medical concern. Detection of cardiovascular involvement may be based on clinical signs, radiographic changes, electrocardiographic (ECG) or echocardiographic abnormalities, or laboratory findings. Emphasis in this chapter is given to diseases having the greatest cardiovascular effects or incidence in practice. The focus of discussion is the cardiovascular effects and their treatment.
Box 13-1 Classification of Important Systemic Disorders That Affect the Heart
HYPERTHYROIDISM
Cardiac Pathophysiology
Indirect Effects
Diagnosis
History and Physical Examination
Therapy
HYPOTHYROIDISM
Cardiac Pathophysiology
Diagnosis
Clinical Pathology
Box 13-2 Some Drugs and Diagnostic Agents that Can Alter Basal Serum Thyroid Hormone Concentrations in Humans and Possibly Dogs
From Feldman EC, Nelson RW: Canine and feline endocrinology and reproduction, 3rd ed. St Louis: WB Saunders, 2004.
Decrease T4 and/or T3 | Increase T4 and/or T3 |
---|---|
Amiodarone (T3) Androgens Cholecystographic agents Diazepam Dopamine Flunixin Furosemide Glucocorticoids Heparin Imidazole Iodide Methimazole Mitotane Nitroprusside Penicillin Phenobarbital Phenothiazines Phenylbutazone Phenytoin Primidone Propranolol Propylthiouracil Radiopaque dyes (ipodate) (T3) Salicylates Sulfonamides (sulfamethoxazole) Sulfonylureas | Amiodarone (T4) Estrogens 5-Fluorouracil Halothane Insulin Narcotic analgesics Radiopaque dyes (ipodate) Thiazides |