Hi all,
Just wanted to make sure I got the right diagnosis for this little one as SAS occurs commonly in large breed dogs.
3 year old, 2.5kg toy poodle which owner recently adopted from a friend. No clinical symptoms. A grade 4/6 heart murmur was auscultated during a routine check up.
Hi all,
Just wanted to make sure I got the right diagnosis for this little one as SAS occurs commonly in large breed dogs.
3 year old, 2.5kg toy poodle which owner recently adopted from a friend. No clinical symptoms. A grade 4/6 heart murmur was auscultated during a routine check up.
Echocardiogram showed severe LV hypertrophy and increase aortic velocity of at least 5m/s. I can also see the fibrous nodule at the level of the subvulvular region. LA/AO ratio is normal. Pulmonary outflow was normal. Mild mitral regurgitation. No tricuspid regurgitation. Aortic insufficiency is also present.
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Comments
Looks like severe SAS to me
Looks like severe SAS to me and possibly mitral valve dysplasia (or beaten up mitral valves) with SAM? Atenolol candidiate?
I am not certain that this
I am not certain that this isn’t mitral valve disease with SAM and a functional narrowing of the aortic outflow tract with dilation of the aorta. The L atrium does not look all that dilated but there sure is thickening of the L ventricular free wall. ? if there is diastolic dysfunction. You are right- not the right breed for SAS.
OK- I committed again.
I guess we can wait and see what EL or Peter has to say.
Looks like vegetative MV and
Looks like vegetative MV and SAM causing dynamic obstruction. The AV valve looks fine and there is no lembus.
Hi all,
Yeah, initially I was
Hi all,
Yeah, initially I was thinking maybe MVD and HOCM but I managed to get views of the MV which is linear and had adequate extension. i’ll attached the photos.
There seems to be some trouble with diastolic relaxation due to the hypertrophy : LVIDd 1.17 (1.27 – 1.85) [cornell normalised ref)
Hi guys, what is our verdict
Hi guys, what is our verdict on this? Eric, after having a look at the mv ( photos attached after), are you still thinking MVD and SAM?
PS: Peter, would love to hear what your thoughts on this.
Thanks guys!
Peter has been on vacation
Peter has been on vacation but I will ping him.
In your first set of images the 6 m/sec velocity looks like its going through the MV and not the lvot. Mr of 6 m/sec makes a lot of sense and to be expected with that vegetative MV and hypertrophied LV free wall. The still images in the second set look like a more innocuous view of the MV but remember this is a 1 mm slice thoguh the structure in 2d so change the angle and things get better or worse depending on the lesion and the angle. in the first set you have obvious MV disease =but not sure that’s the whole story.
Honestly I think your best bet is a telemed consultation and ensure you have full lvot positioning for cw doppler and full CF. This could be primary MV dysplasia or a combined defect with SAS just not evident in the views here but need full image sets to evaluate the whole heart is beyond a forum post platform but at least you got some solid input so far.
Thanks Eric! Appreciate the
Thanks Eric! Appreciate the help. I know it’s difficult to evaluate the heart with limited views. We don’t have telemed in australia. I have advised to refer the patient to a cardiologist specialist for further work up. Will let u know what he finds:)
Thank you!
I do telemed through Sonopath
I do telemed through Sonopath all the time.
Just need to submit your cine’s and images.