猫心肌病: 1. 一般概念

作者：Mark D Kittleson，Etienne Côté

摘要来源：https://doi.org/10.1177/1098612X211021819

摘要

临床相关性

猫心肌病是成年家猫中最常见的心脏病。目前已经确定多种分型（见第2，3部分），其中肥厚型心肌病（HCM）最常见。临床上常常难以区分心肌病类型。 患有隐性心肌病的猫在体格检查时不一定会有明显异常（例如心脏杂音、奔马音）或影像呈现心脏肥大。患病严重的猫可能发展出心衰的症状（例如呼吸困难、呼吸急促）或系统性动脉血栓栓塞（ATE）（例如疼痛和瘫痪），此时可能会猝死。治疗通常不能改变疾病从隐性到显性的过程，一旦临床症状明显，无论哪种心肌病，治疗方法都一样。然而，区分心肌病和正常生理变化可能对预后很重要。

易感群体

不论性别和品种，任何3月龄以上的家猫都可能患心肌病，其中混血猫最为常见，但某些品种猫极易患HCM。

诊断

基于体格检查结果、胸片影像以及心脏生物标记物，可能会怀疑猫患有隐性心肌病，但该病通常在临床上是无症状的。最终确诊的检查是超声心动图。通过放射影像可确诊左心衰（肺水肿和/或胸腔积液），但床旁超声和心房钠尿肽（NT-proBNP）生物标记物检测也很有用，这样可以避免拍片导致的应激。

关键发现

病理生理学知识可以帮助兽医诊断猫心肌病，并了解它如何发展以及出现什么样的临床症状（心衰，ATE）。现有的检查手段都有其优势和局限性，意识到这一点可以帮助兽医给患猫提供最佳治疗方案

结论

在隐性（轻症到重症）和显性（重症）阶段，都存在数种猫心肌病。 心衰和ATE是重症心肌病最常见的临床症状，各种心肌病在该阶段时必须给予治疗。一旦显性病征出现，长期预后谨慎或不良。

不确定的方面

在隐性（轻症到重症）和显性（重症）阶段，都存在数种猫心肌病。 心衰和ATE是重症心肌病最常见的临床症状，各种心肌病在该阶段时必须给予治疗。一旦显性病征出现，长期预后谨慎或不良。

关键词

心肌病, 心肌疾病, 超声心动图, 心衰, 动脉血栓栓塞

参考文献

心肌病, 心肌疾病, 超声心动图, 心衰, 动脉血栓栓塞

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