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Ascites and endocardiosis

Sonopath Forum

Sonopath Forum

Ascites and endocardiosis

Dear All,

Benny is a 10 year old beagle patient with right sided heart failure. 

He already has mild ascites and dilatated v. cava.

He also has mitral prolapse, mitral endocardiosis, dilatated left atrium and left sided volume overload. No pulmonal oedema yet.

MR yet: 5,5 m/s-which fills the complete left atrium, Aorta ok, TR yet: 3,5 m/s, and severe pulmonal insuff is 2,5 m/s and the pulmonal flow is 2 m/s- the whole pulmonic low profile is abnormal. 

I have not seen a pulmonic profile like this according to mitral endocardiosis.

Dear All,

Benny is a 10 year old beagle patient with right sided heart failure. 

He already has mild ascites and dilatated v. cava.

He also has mitral prolapse, mitral endocardiosis, dilatated left atrium and left sided volume overload. No pulmonal oedema yet.

MR yet: 5,5 m/s-which fills the complete left atrium, Aorta ok, TR yet: 3,5 m/s, and severe pulmonal insuff is 2,5 m/s and the pulmonal flow is 2 m/s- the whole pulmonic low profile is abnormal. 

I have not seen a pulmonic profile like this according to mitral endocardiosis.

The dog is on tripple therapy now- but i am concerned a bit to give the pimobendan.

What is Your opinion?

Thank Youu!

Rita

Comments

EL
December 14, 2019 at 4:22 pm -

Hmmm would need more left

Hmmm would need more left sided views here as thats pretty wicked PI as well and failing rt heart wiht dilated HV.

Masybe Peter would have more input if sildenafil is in order. Often as the right heart fails the TR velocities can drop or be underestimated. The hv dilation is key here.

Peter
December 14, 2019 at 4:43 pm -

Hi
As Eric  mentioned, more

Hi

As Eric  mentioned, more views would be helpful here. Although the PI velocities are borderline high, the PA flow profile does not fit with PHT (too much flow here and PI velocities too low). 

Possible reasons for right sided failure here are:

  • Pulmonic stenosis with a failing right heart that causes vmax across RVOT to decrease (maybe as well a bit underestimated)
  • ASD or VSD causing an increase of RVOT velocities due to L-R shunt

So, more views would be great.

I would not worry about pimo here –  I usually use it as well in PS cases when the right heart fails (off lable, though).

Peter

pacsit
December 15, 2019 at 6:39 pm -

Thank You!
I will call back

Thank You!

I will call back the dog after 3 weeks of treatment for controll-i will make more videos!

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