10 yr MN E Bulldog ,ventral alv lung pattern- TX aspiration pneumonia(mildWBC). Follow up= int. pattern with cardiomegaly. TX low dose furosemide and Pimobendan. Follow up; Cough almost resolved, Echo: large LA with septal bowing and restrictive MV profile. Normal LV fractional shortening(36%) with mild mitral regurgitation MV Reg. vel=4.8m/s, EPSS=.42cm, TV regurge velocity = 3.2m/s. Mild PE with mild diastolic collapse RA. Mild HVC. Mass affect at the level of the LA/L AUR on RSA view and above the PA in the LSA slight oblique view. Thoughts?
Comments
Chemodectoma definitely a possibilty but could also be a primary/metastatic lesion such as hemangiosarcoma. Would recommended an abdominal ultrasound.
Thank you! Dog was pretty good but would get stressed and develop a bluish hue with a bit of probing. Owner was against the use of a mild sedative so I got what I could. What did you think about the LA size and the restrictive mitral inflow.? A consequence of neoplasia?? If neoplasia related do you think less likely a chemodectoma and more likely an infiltrative type process?
Ao body tumor/chemodectoma, fibrosarcoma, hsa all possible there is a bit of volume overload and poor contractility and non tamponade pc eff. i I doubt HSA though as position and echotexture doesnt fit. Maybe add an ACEi and a touch of lasix to reduce the volume overload more but make adjustments gradually monitor bp bun create and abdominal us for comorbidities.
Yes! The MV regurge produced only a mild jet and measured just below 5m/s. With the mild diastolic RA collapse , the furosemide and Pimobendin on board I figured a bigger hit to preload may have been observed that would have affected the systolic LV dimension more and possibly LA pressure estimates . In your experience would you expect to see a more significant heart dysfunction and larger chamber sizes if not on the meds already? Do you think this presentation is an emerging DCM phenotype possibly from the neoplasia or more related to the MV insufficiency?