A 10-year-old neutered male Boston Terrier was presented for exercise intolerance. The physical exam was uneventful. Blood and urinalyses were normal.
A 10-year-old neutered male Boston Terrier was presented for exercise intolerance. The physical exam was uneventful. Blood and urinalyses were normal.
Large aortic body mass with secondary severe pulmonary hypertension.
The echocardiogram in this patient revealed a severely enlarged echogenic aortic body mass that measured 7.2 x 6.43 cm overlying the left atrium. Therefore, LA:AO and LA max measurements were not performed. Mitral insufficiency was also present. The left sided volume was adequate at this time, and no significant overload was present. Severe right sided enlargement and moderate to severe tricuspid insufficiency was noted, which is consistent with pulmonary hypertension. Left-sided inflow is likely compromised by the aortic body mass. The tricuspid insufficiency velocity was 4.11 m/sec.
Systemic blood pressure measurements, sildenafil at 1 mg/kg BID increasing over 7-10 days to 1.5 mg/kg, and aspirin therapy were recommended for this patient. A follow-up echocardiogram was advised, and a guarded long-term prognosis was given. Recheck echocardiogram revealed a persistently elevated TR jet of 3.8 m/sec, but clinically the patient was stable in the following 3 months with minimal to no clinical signs.
Structural or arrhythmogenic cardiac disease, orthopedic disease, occult neoplasia, endocrinopathy (hypothyroidism, Addison’s, etc.)
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