Hi everyone,
I would like a 2nd opinion on this echo I recently did. I know SAS is common in large breed dog hence I’m doubting my diagnosis. 8 month old male minature schnauzer. Patient was presented for acute abdominal pain and a heart murmur was auscultated as an incidental finding.
Turbulence was observed at the aortic flow with increased transaortic flow velocity of 423.5cm/s. There was no aortic insufficiency. Both LVIDd and LVIDs and decreased but preserved normal diastole septal and free wall thickness. No other congenital findings ( VSD or Pulm stenosis).
Hi everyone,
I would like a 2nd opinion on this echo I recently did. I know SAS is common in large breed dog hence I’m doubting my diagnosis. 8 month old male minature schnauzer. Patient was presented for acute abdominal pain and a heart murmur was auscultated as an incidental finding.
Turbulence was observed at the aortic flow with increased transaortic flow velocity of 423.5cm/s. There was no aortic insufficiency. Both LVIDd and LVIDs and decreased but preserved normal diastole septal and free wall thickness. No other congenital findings ( VSD or Pulm stenosis).
The profile flow of the aorta is suggestive of a dynamic obstruction(late peaking velocity). I cant see any SAM.
Questions:
1. velocities exceeding 250cm/s is consistent with aortic stenosis, correct?
2. what caused the decreased LVIDd and LVIDs
Comments
There seems to be a
There seems to be a subvalvular lembus in video 1 which is typical for sas. Your veloicities are certainly consistent with moderate sas. But watch your lvot angle as you are not completely apical and this will cause for underestimation of the ao velocity. See the suspected lembus screen shot and peters measurement of a lembus/stenosis in sas case and ideal lvot positioning from the normals dvd (http://sonopath.com/products/dvd), a peter modler sas view and a couple of mine (sas and normal lvot).
Basic search subaortic stenosis (more being loaded )
http://sonopath.com/members/case-studies/search?text=subaortic+stenosis&species=All
and Peter’s page of SAS and lots of cardio pathology cases
http://sonopath.com/about/specialists/peter-modler-dvm-dipl-tzt
Thank you Eric!
I see that
Thank you Eric!
I see that you had 2 measurements for the AO flow, one just beyond the AV and one post AV. Is this routinely done for SAS to see where the stenosis is? Meaning if velocity is highest just beyond the AV = SAS ?
yes before the av you assess
yes before the av you assess for AI and after the AV you assess for outflow velocity.
Technically bot the av and the pv you assess pre valve and post valve.