Why can’t I see the cardiac mass on left sided views?

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Why can’t I see the cardiac mass on left sided views?

  • 14 year old FS pitbull mix
  • Slow onset of ascites over the past month
  • Cytology done on abdominocentesis showed a modified transudate
  • Abdominal radiographs show hepatomegaly and decreased detail
  • Initial rule outs included carcinomatosis, abdominal mass, caudal vena cava thrombosis, right heart failure
  • Abdominal ultrasound showed a marked amount of anechoic free fluid, mildly clumping omentum and mesentery, splenomegaly, and hepatomegaly with dilated hepatic veins
    • 14 year old FS pitbull mix
    • Slow onset of ascites over the past month
    • Cytology done on abdominocentesis showed a modified transudate
    • Abdominal radiographs show hepatomegaly and decreased detail
    • Initial rule outs included carcinomatosis, abdominal mass, caudal vena cava thrombosis, right heart failure
    • Abdominal ultrasound showed a marked amount of anechoic free fluid, mildly clumping omentum and mesentery, splenomegaly, and hepatomegaly with dilated hepatic veins
    • Brief scan of the heart shows what appears to be a mass filling the RA and RV on right sided views. 
    • Left parasternal views did not show the mass.  I am also not seeing pericardial effusion. 
    • Also, when I first put the probe on the chest, I could see the mass but not the heart.
    • Why am I not seeing the mass on left sided views?  Can the mass be both inside and outside of the heart?

Comments

EL

This has th eechogenicity of

This has th eechogenicity of an aortic body tumor/chemodectoma and grows differently out the base of the heart and slowly as opposed to a typical right aurciular hemangiosarcoma and doesnt have pc effusion as readily as HSA. These guys can live for quite a long time with these an Pittys are well represented along with brachycephalic breeds.

EL

This has th eechogenicity of

This has th eechogenicity of an aortic body tumor/chemodectoma and grows differently out the base of the heart and slowly as opposed to a typical right aurciular hemangiosarcoma and doesnt have pc effusion as readily as HSA. These guys can live for quite a long time with these an Pittys are well represented along with brachycephalic breeds.

Electrocute

So on my right parasternal

So on my right parasternal transverse views, how do I know if the mass is truly in the RA and RV or if it is just indenting them? 

Electrocute

So on my right parasternal

So on my right parasternal transverse views, how do I know if the mass is truly in the RA and RV or if it is just indenting them? 

EL

Its deriving and avvolging

Its deriving and avvolging the aorta typical of chemodectoma as you can see in your still image. If it reaches the rest of th eheart its from expansion to or over the rest of the heart.

EL

Its deriving and avvolging

Its deriving and avvolging the aorta typical of chemodectoma as you can see in your still image. If it reaches the rest of th eheart its from expansion to or over the rest of the heart.

Electrocute

Going back to my original

Going back to my original question,I want to be able to say with confidence that the mass is inside the RV and RA as that is what I am seeing on my RP transverse views.  Can compression of the RA and RV give the same appearance?  It just bothered me that I could not confirm RA and RV involvement on my left sided cranial views. 

Electrocute

Going back to my original

Going back to my original question,I want to be able to say with confidence that the mass is inside the RV and RA as that is what I am seeing on my RP transverse views.  Can compression of the RA and RV give the same appearance?  It just bothered me that I could not confirm RA and RV involvement on my left sided cranial views. 

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