Left atrial enlargement in a young cat

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Left atrial enlargement in a young cat

  • A vet tech recently rescued this young adult cat from an abandoned home.  The previous owner would stop by to feed once weekly.
  • Cat is BAR and acting normal but the rDVM ausculted a cardiac murmur.
  • I am seeing an enlarged left atrium and auricle, markedly increased LA:Ao ratio, and what looks like abnormal mitral valve motion and conformation. The tricuspid valve shows normal motion and no TVI.
    • A vet tech recently rescued this young adult cat from an abandoned home.  The previous owner would stop by to feed once weekly.
    • Cat is BAR and acting normal but the rDVM ausculted a cardiac murmur.
    • I am seeing an enlarged left atrium and auricle, markedly increased LA:Ao ratio, and what looks like abnormal mitral valve motion and conformation. The tricuspid valve shows normal motion and no TVI.
    • Cardiac measurements are as follows:  IVSd=4.0, LVIDd=13.1, LVPWd=5.5, IVSs=6.5, LVIDs=8.3, LVPWs=6.4.  FS is decreased at 34%.  LA=14.3, Ao=6.4, La/Ao=2.2.  HR=195bpm.
    • Pulmonic valve and outflow tract appear normal with a PV of 1.0m/s.  Ao vel is 1.0m/s. 
    • Is this mitral valve dysplasia?  Are the vegetative changes seen on the apical views suggestive on endocarditis? Or am I just looking at some kind of unclassified cardiomyopathy?
    • Any conservative medical managment recommendation?

     

     

Comments

EL

There is volume overload in

There is volume overload in the LA and RA and minor pc effusion in your third view. Doesnt really matter what you call it but UCM fits here but the MV is thickened and given thee Hx consier endocarditis… Baytril, Clindamycin trial never hurst anything… then maybe recheck in 2-3 weeks if clinically normal and maybe an ACEi… these are so controversial when you tx them but if that slight pc effusion is real ion other views then consider infectious for sure as vasculitis will do this as well as neoplasia and CHF.

EL

There is volume overload in

There is volume overload in the LA and RA and minor pc effusion in your third view. Doesnt really matter what you call it but UCM fits here but the MV is thickened and given thee Hx consier endocarditis… Baytril, Clindamycin trial never hurst anything… then maybe recheck in 2-3 weeks if clinically normal and maybe an ACEi… these are so controversial when you tx them but if that slight pc effusion is real ion other views then consider infectious for sure as vasculitis will do this as well as neoplasia and CHF.

Electrocute

Thanks Eric.  Would you add

Thanks Eric.  Would you add in lasix?

Electrocute

Thanks Eric.  Would you add

Thanks Eric.  Would you add in lasix?

EL

With the LA shown in the

With the LA shown in the second clip I would add lasix and reevaluate clinically and echo but more conservative people wouldnt since not in traditional wet heart failure yet… though word is on the streets that Cardio is attempting to redefine chf and not just based on wet lungs (left chf) or ascites (right chf) as a definition of chf… but you know how those things go.

EL

With the LA shown in the

With the LA shown in the second clip I would add lasix and reevaluate clinically and echo but more conservative people wouldnt since not in traditional wet heart failure yet… though word is on the streets that Cardio is attempting to redefine chf and not just based on wet lungs (left chf) or ascites (right chf) as a definition of chf… but you know how those things go.

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