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The effect of endocrine disease on the cardiovascular system
/content/chapter/10.22233/9781910443866.chap5
The effect of endocrine disease on the cardiovascular system
- Author: Luca Ferasin
- From: BSAVA Manual of Canine and Feline Endocrinology
- Item: Chapter 5, pp 29 - 36
- DOI: 10.22233/9781910443866.5
- Copyright: © 2023 British Small Animal Veterinary Association
- Publication Date: August 2023
Abstract
This chapter focuses on the effect of endocrine diseases on the cardiovascular system. It reviews the cardiac abnormalities that can arise from changes in specific endocrine gland function, particularly of the thyroid gland. The chapter discusses the physiological relationship between the heart and thyroid gland and the effects of thyroid hormones on cardiovascular function, including changes in vascular resistance, heart rate, contractility, and blood volume. The cardiovascular effects of disorders of the pituitary and adrenal glands and the pancreas are also explored.
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Figures
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5.1
Thyroid hormone effects on the heart and peripheral vasculature. RAAS = renin–angiotensin–aldosterone system; SVR = systemic vascular resistance; T3 = triiodothyronine; T4 = thyroxine. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
(Redrawn after
Klein and Danzi, 2007
) © 2023 British Small Animal Veterinary Association
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5.1
Thyroid hormone effects on the heart and peripheral vasculature. RAAS = renin–angiotensin–aldosterone system; SVR = systemic vascular resistance; T3 = triiodothyronine; T4 = thyroxine. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
(Redrawn after
Klein and Danzi, 2007
)
/content/figure/10.22233/9781910443866.chap5.fig5_2
5.2
Echocardiographic images obtained from a cat with overt hyperthyroidism and acute signs of congestive heart failure. (a) Right parasternal four-chamber long-axis view. (b) Right parasternal short-axis view at the level of the chordae tendineae. Both images show severe myocardial damage characterized by four-chamber dilatation, thinning of the left ventricular free wall, bridging scar in the mid-left ventricular cavity and mild pleural effusion. (c) M-mode image of the left ventricle in right parasternal short-axis view at the level of the chordae tendineae showing a thin left ventricular free wall, which also displayed increased echogenicity and regional hypokinesis suggestive of replacement fibrosis secondary to myocardial ischaemia. © 2023 British Small Animal Veterinary Association
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5.2
Echocardiographic images obtained from a cat with overt hyperthyroidism and acute signs of congestive heart failure. (a) Right parasternal four-chamber long-axis view. (b) Right parasternal short-axis view at the level of the chordae tendineae. Both images show severe myocardial damage characterized by four-chamber dilatation, thinning of the left ventricular free wall, bridging scar in the mid-left ventricular cavity and mild pleural effusion. (c) M-mode image of the left ventricle in right parasternal short-axis view at the level of the chordae tendineae showing a thin left ventricular free wall, which also displayed increased echogenicity and regional hypokinesis suggestive of replacement fibrosis secondary to myocardial ischaemia.
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5.3
Electrocardiographic recording from a dog with hypothyroidism. The trace shows profound sinus bradycardia at approximately 25 bpm with low-voltage QRS complexes (50 mm/s, 10 mm/mV, lead II). © 2023 British Small Animal Veterinary Association
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5.3
Electrocardiographic recording from a dog with hypothyroidism. The trace shows profound sinus bradycardia at approximately 25 bpm with low-voltage QRS complexes (50 mm/s, 10 mm/mV, lead II).
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5.4
Echocardiographic images of a diabetic cat with hypersomatotropism and congestive heart failure. (a) Right parasternal four-chamber long-axis view. (b) Right parasternal short-axis view at the level of the chordae tendineae. Both images show significant left ventricular myocardial thickening. (c) Right parasternal short-axis view at the level of the heart base showing significant left atrial enlargement. © 2023 British Small Animal Veterinary Association
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5.4
Echocardiographic images of a diabetic cat with hypersomatotropism and congestive heart failure. (a) Right parasternal four-chamber long-axis view. (b) Right parasternal short-axis view at the level of the chordae tendineae. Both images show significant left ventricular myocardial thickening. (c) Right parasternal short-axis view at the level of the heart base showing significant left atrial enlargement.
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5.5
Echocardiographic images of a cat with hypersomatotropism and a significantly enlarged aortic root (aortic aneurysm) and diastolic aortic insufficiency. (a) Right parasternal five-chamber long-axis view showing the enlarged aorta. (b) Doppler interrogation obtained from the same view showing aortic regurgitation. (c) Right parasternal short-axis view at the level of the heart base showing significant aortic enlargement. (d, e) Normalization of the aortic dimension and disappearance of the aortic insufficiency 6 months after surgical hypophysectomy. LA = left atrium; LVOT = left ventricular outflow tract. © 2023 British Small Animal Veterinary Association
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5.5
Echocardiographic images of a cat with hypersomatotropism and a significantly enlarged aortic root (aortic aneurysm) and diastolic aortic insufficiency. (a) Right parasternal five-chamber long-axis view showing the enlarged aorta. (b) Doppler interrogation obtained from the same view showing aortic regurgitation. (c) Right parasternal short-axis view at the level of the heart base showing significant aortic enlargement. (d, e) Normalization of the aortic dimension and disappearance of the aortic insufficiency 6 months after surgical hypophysectomy. LA = left atrium; LVOT = left ventricular outflow tract.
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5.6
Cardiovascular effects of hypoadrenocorticism with associated hyperkalaemia and hypovolaemia in a dog. (a) The electrocardiographic trace shows sustained atrial standstill with a junctional escape rhythm of approximately 40 bpm, mildly small R waves (1.3 mV) and prolonged QRS duration (80 ms) (50 mm/s, 10 mm/mV, lead II). (b, c) Thoracic radiographs show small heart size (microcardia), decreased pulmonary vasculature and small caudal vena cava. (d–f) Echocardiographic images show pseudo-hypertrophy (thickened myocardial wall, reduced left ventricular diameter and reduced left atrial size). (d) Right parasternal four-chamber long-axis view. (e) Right parasternal short-axis view at the level of the papillary muscles. (f) Right parasternal short-axis view at the level of the heart base. © 2023 British Small Animal Veterinary Association
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5.6
Cardiovascular effects of hypoadrenocorticism with associated hyperkalaemia and hypovolaemia in a dog. (a) The electrocardiographic trace shows sustained atrial standstill with a junctional escape rhythm of approximately 40 bpm, mildly small R waves (1.3 mV) and prolonged QRS duration (80 ms) (50 mm/s, 10 mm/mV, lead II). (b, c) Thoracic radiographs show small heart size (microcardia), decreased pulmonary vasculature and small caudal vena cava. (d–f) Echocardiographic images show pseudo-hypertrophy (thickened myocardial wall, reduced left ventricular diameter and reduced left atrial size). (d) Right parasternal four-chamber long-axis view. (e) Right parasternal short-axis view at the level of the papillary muscles. (f) Right parasternal short-axis view at the level of the heart base.
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5.7
Twenty-four hour ambulatory (Holter) electrocardiography recording from a dog with phaeochromocytoma and hypertension. The trace shows approximately 3 minutes of inappropriate (during resting) sinus tachycardia, approaching 200 bpm and characterized by abrupt onset and cessation. © 2023 British Small Animal Veterinary Association
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5.7
Twenty-four hour ambulatory (Holter) electrocardiography recording from a dog with phaeochromocytoma and hypertension. The trace shows approximately 3 minutes of inappropriate (during resting) sinus tachycardia, approaching 200 bpm and characterized by abrupt onset and cessation.