NAVLE Cardiovascular

Canine Congestive Heart Failure Study Guide

Congestive heart failure (CHF) is a clinical syndrome that occurs when the heart can no longer pump sufficient blood to meet the body's metabolic demands, or can only do so at elevated filling pressures.

Overview and Clinical Importance

Congestive heart failure (CHF) is a clinical syndrome that occurs when the heart can no longer pump sufficient blood to meet the body's metabolic demands, or can only do so at elevated filling pressures. In dogs, CHF most commonly results from myxomatous mitral valve disease (MMVD), accounting for approximately 75% of all canine heart disease cases. The second most common cause is dilated cardiomyopathy (DCM), which predominantly affects large and giant breed dogs. Understanding the pathophysiology, clinical presentation, diagnostic approach, and treatment of CHF is essential for NAVLE success and clinical practice.

Heart failure in dogs carries significant morbidity and mortality. Approximately 10% of dogs presented to primary care veterinary practices have heart disease, making cardiovascular conditions a major component of the NAVLE examination. Early recognition and appropriate staging of heart disease directly impacts treatment decisions and patient outcomes.

Left-Sided CHF Right-Sided CHF
Pathophysiology: Blood backs up into pulmonary veins Elevated left atrial pressure Fluid leaks into pulmonary interstitium and alveoli Pathophysiology: Blood backs up into systemic veins Elevated right atrial pressure Fluid accumulates in body cavities
Clinical Signs: Cough (especially at night) Tachypnea, dyspnea Orthopnea Pulmonary crackles Exercise intolerance Syncope Clinical Signs: Ascites (abdominal distension) Jugular venous distension Hepatomegaly Peripheral edema Pleural effusion Weight gain
Common Causes: MMVD (most common) DCM Patent ductus arteriosus Aortic stenosis Common Causes: Tricuspid valve disease Heartworm disease Pulmonic stenosis DCM (biventricular)

Pathophysiology of Congestive Heart Failure

Hemodynamic Basis

Heart failure develops when cardiac output becomes insufficient to meet tissue oxygen demands. The failing heart triggers compensatory mechanisms including:

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