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15_00081 Minko S Narrow LVOT/AO

Case Study

15_00081 Minko S Narrow LVOT/AO

A 12-year-old MN Siamese cat was presented for evaluation of either syncopal episodes or seizures. On physical examination, arrhythmia and bradycardia were noted, with a HR that fluctuated from 80 to 160 BPM. Systolic BP was normal.

A 12-year-old MN Siamese cat was presented for evaluation of either syncopal episodes or seizures. On physical examination, arrhythmia and bradycardia were noted, with a HR that fluctuated from 80 to 160 BPM. Systolic BP was normal.

Sonographic Differential Diagnosis

The enlarged left atrium (mild enlargement) may be either a cause of mild regurgitation (which could also be due to SAM) or a consequence of restriction to ventricular filling. The morphology and function of the heart (on echo) do not give any cause for the clinical problems.

Image Interpretation

Normal left and right ventricle, an enlarged left atrium, and a slightly subnormal LVOT and AO diameter. CDI shows some slight mitral regurgitation. There is also possibly mild SAM but this cannot be determined on the 2D-clips. The AV occasionally flutters in systole; this may be due to turbulence within the LVOT. The concomitant ECG shows marked arrhythmia but the Sono-ECG is non-diagnostic.

DX

Normal left ventricle, enlarged left atrium, narrow LVOT/AO not of clinical importance.

Outcome

A Holter recording is strongly recommended in order to define the type and extent of the arrhythmia, as well as if the syncopal episodes occur during bradycardia, tachycardia or both. If this is not possible for the owner, a long ECG strip, with at least 3 leads, may help determine whether medication is indicated.

Comments

No further outcome provided.

Clinical Differential Diagnosis

Bradycardia – primary conduction anomaly, vagal-induced bradycardia, myocarditis, organophosphate toxicity, intra-cranial disease. Seizures – intra-cranial disease, infectious, metabolic, toxic, idiopathic.

Sampling

None

Patient Information

Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete

Clinical Signs

  • Seizures
  • Syncopal episodes

Exam Finding

  • Arrhythmia
  • Bradycardia
  • Fluctuating heart rate

Images

15_00081_mmode_02_0304201207541515_00081_LAAO_01_03042012075513

Clinical Signs

  • Seizures
  • Syncopal episodes