Presented for evaluation of an arrhythmia that had been picked up on routine physical examination. An ECG revealed several atrial premature contractions and ventricular premature contractions.
Presented for evaluation of an arrhythmia that had been picked up on routine physical examination. An ECG revealed several atrial premature contractions and ventricular premature contractions.
Severe hypertrophic cardiomyopathy which has resulted in myocardial failure.
Fractional shortening is low.
Pericardial effusion.
Severe left atrial dilation, forming thrombus in the left atrium.
Extremely poor prognosis.
The echocardiogram in this patient demonstrated severe dilation of the left atrium. In
addition there was a large amount of echogenic swirling debris within the left atrium. This is representative of a “smoke” or echoes which is indicative of a forming thrombus. The cranial
and caudal mitral valve leaflets presented normal linear structure, extension in systole, and union in diastole. There was considerable hypertrophy of the left ventricular free wall and
mild pericardial effusion. The left ventricular outflow tract demonstrated normal laminar flow. Subjective assessment of the right atrium and auricle revealed normal size, structure and content. No evidence of masses was noted. Tricuspid valvular assessment demonstrated linear morphology. The right ventricle was of normal size (1/3 diameter of LV), chordae structure, myocardial echogenicity and thickness. No evidence of dilation nor restriction was noted. Pulmonic tract assessment revealed normal valve structure, laminar flow, and diameter (approx.1:1 pa/ao ratio. No visible pleural effusion, ascites or hepatic vein dilation. The
patient heart rate was very high mostly likely to the arrhythmia. TI velocity 0.42
No further outcome at this time.
We would recommend plavix at ¼ tablet once daily, a beta blocker, atenolol and consider an extra label use of pimobendan at 0.2mg/kg once daily. A recheck examination would be recommended in one month’s time.
Heart – cardiomyopathy (dilated, hypertrophic), myocarditis, pericardial effusion
Metabolic – anemia, acidosis, electrolyte anomalies (calcium, potassium, magnesium)
Splenic disease – splenitis, neoplasia, hypersplenism
None