Provided are some pics of an 8kg, 11 year old female spayed DMH presented for ultrasound. Pre-surgical blood work revealed a blood glucose of 15.1 with normal renal values. ECG suggested widening of the QRS complex and right axis deviation possibly normal variation. A SNAP pro BNP was abnormal. A thyroid test was not performed. Sedated with Gabapentin and given butorphanol IV prior to the study (mildly effective).Imaging was fair. NIBP was 145/119mmHg with a MAP of 125. The LAD measured 15.4mm -16.5mm. No abnormal flow was noted. Doppler E’ of 6.1cm/s noted at the free wall annulus. Sorry for the poor video! Your thoughts on this case.
Comments
Looks very normal to me Dan. I don’t use the hcm phenotype til I have a solid ivsd or pwd of 0.6 cm and maybe even more if a big main coon as I think 0.6 is likely normal for large breed cats. Then I will emphasize it more if I have other things that suggest HCM like dynamic or fixed obstruction, sectorial hypertrophy (even if < 0.6 cm), infarcts, remodeling, MR, LAE and such. ECGs are highly variable and often non specific so I would rely on the echo for any pathology and yours looks very normal here. I have no issue with anesthesia on this heart
Thanks! There was subjective hypertrophy of a papillary muscle and a couple long axis 2D LPW measures were in the grey zone but nothing more than that. I think the ECG, abnormal SNAP and Pulsed TD made me feel I had to be missing something?