Case Study

Hypertrophic cardiomyopathy and mitral insufficiency in a 14 year old MN DSH cat with weight loss

A 14-year-old MN DSH cat was presented for losing weight.

A 14-year-old MN DSH cat was presented for losing weight.

Sonographic Differential Diagnosis

Hypertrophic cardiomyopathy (primary HCM or secondary due to systemic disease such as hyperthyroidism or hypertension) with myocardial fibrosis. Mitral insufficiency and occasional systolic anterior motion.

Image Interpretation

The left ventricle demonstrated normal volume, excessive septal and free wall diastolic thicknesses, and prominent papillary muscles consistent with hypertrophic cardiomyopathy. Ventricular function was exaggerated consistent with a hyperdynamic state. Occasional systolic anterior motion (SAM) was noted in the left ventricular tract. Turbulence of the left ventricular outflow tract was noted. Mitral insufficiency was present and measured 4.8 m/sec.

DX

Hypertrophic cardiomyopathy, mitral insufficiency

Outcome

An ECG was performed, and no arrhythmias were noted. Heart rate at home is below 180 bpm, so Atenolol is not recommended at this time.

Comments

Atenolol therapy would be recommended at 6.25-12.5 mg s.i.d. to b.i.d. if resting heart rate over 170 is noted. The target heart rate is 150-170 beats per minute in a cat. A recheck echocardiogram is recommended in 6 months or earlier if any developing clinical signs are noted.