An 11-month-old NM bulldog was presented for evaluation of a grade 4/6 holosystolic murmur.
An 11-month-old NM bulldog was presented for evaluation of a grade 4/6 holosystolic murmur.
An 11-month-old NM bulldog was presented for evaluation of a grade 4/6 holosystolic murmur.
An 11-month-old NM bulldog was presented for evaluation of a grade 4/6 holosystolic murmur.
There is severe subaortic stenosis and pulmonic stenosis present in this case. The PS could possibly be treated by valvular dilatation (if an R2A anomaly of the coronary system is ruled out by angio) but the subaortic stenosis cannot. So I would speak honestly to the owners. The life expectancy for such patients is usually less than 3 years. I would administer Atenolol (starting at 0,5 mg/kg twice and increasing weekly to 2 mg/kg twice) to reduce pressure gradients and perhaps decrease the risk for syncope. The prognosis is poor. If the owners want to treat the PS it should be performed soon. But remember that the problem cannot be solved as a whole.
moderate left and severe right ventricular concentric hypertrophy. The mitral valve seems thickened, the anterior leaflet less mobile. During systole there is clear evidence of SAM of the anterior mitral leaflet. The left and right atrial sizes are normal. Below the aortic valve there is some fibromuscular ridge visible causing narrowing of the LVOT. CDI reveals severe turbulence within the LVOT and concomitant regurgitation into the left atrium as a consequence of SAM. Velocities across the LVOT and RVOT are 4,5 m/s and 5,2 m/s respectively with the profiles showing some dynamic components.
Pulmonic stenosis, aortic stenosis, ASD, VSD
None