Senior larger breed dog with episodes of collapse and history of a left-sided murmur.

-moderate MR 4.4 m/s, other valves competent

-LA:Ao 1.87

-FS 45.7%

-LVOT max = 1.6 m/s

-small volume pericardial effusion with tamponade

-normal PA, no evidence of PH

I don’t associate MR with normal contractility with pericardial effusion.  Are there 2 separate disease processes going on or am I missing something?

Thanks!