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ASD?

Sonopath Forum

– 12 year old FS 2.9 kg Yorkie X presented with cough and mild exercise intolerance SSR 28-32

– echo showed severe LAE, dilated LV and mild pericardial effusion assumed to be secondary to CHF as there is no evidence of a cardiac tumour or left atrial tear (patient is pretty stable)  DDx  Stage C MMVD

– owner declined chest rads;  cardiac meds have been started

– I think there is also an ASD in this patient on 2-d and colour Doppler? I  assume this is incidental as it has not caused any problems

 

– 12 year old FS 2.9 kg Yorkie X presented with cough and mild exercise intolerance SSR 28-32

– echo showed severe LAE, dilated LV and mild pericardial effusion assumed to be secondary to CHF as there is no evidence of a cardiac tumour or left atrial tear (patient is pretty stable)  DDx  Stage C MMVD

– owner declined chest rads;  cardiac meds have been started

– I think there is also an ASD in this patient on 2-d and colour Doppler? I  assume this is incidental as it has not caused any problems

 

Comments

randyhermandvm

Looks like one to me. The R

Looks like one to me. The R atrium seems dilated too.

Any tricuspid regurgitaion. The the hepatic circulation look OK to indicate

R side heart disease. Any possibility of pulmonary hypertension?

Guess we will wait for the experts.

Jacquie- have you had any experience with Mexilitine? See the previous post.

Hard to believe he could go all those many years with what appears to be ASD. Im 

sure EL and Peter will clarify

Pankatz

Hi Randy
Small TR jet and the

Hi Randy

Small TR jet and the highest velocity I could get was 2.7 m/s. The pulmonary artery was midly dilated. I thought the CVC and the heptic veins looked mildly dilated – no ascites.

I think mexilitine was recommended in a case I scanned at another clinic a while ago in a patient with an arrhythmia that was diagnosed on ECG via telemed but otherwise I have had no experience with it. I recall there was no structural heart disease on echo with that one.  With your case, at 16, systemic disease could be an underlying concern. Would be nice to scan the abdomen if the owners would let you.

randyhermandvm

Thanks Jacquie. All the labs

Thanks Jacquie. All the labs came out normal on that dog.

I am going to try him on the Mexilitine and see if his rhythm returns to normal.

 

EL

I see what you are seeing but

I see what you are seeing but Im more concerned with the poc effusion and what the right auricle looks like. Not sure if thats artifact or a mass coming in in the base of the right atrium in your third video. PC effusion in this valve dog with mv prolapse we have to think of LA tear as well. If that ASD is real its small and may be insignificant. I always get concerned for angle drop out here at the AS so I would do duplex pw/cw doppler over the color and get really good sdep echo position 3 views of the right auricle.

Pankatz

Thanks EL -I see that in the

Thanks EL -I see that in the second video and thought the same for a possible tumour but the right auricluar tumour shot was clean and I didn’t see it anywhere else. I guess not finding a tumour, doesn’t rule it out.

I know it is more common in cats, but can CHF cause pericardial effusion in dogs? (if atrial tear has not happened)

EL

Not usually .. I have seen it

Not usually .. I have seen it in very chronic right chf but very rare to have pc effusion in dogs if not neoplasia, atrial rupture or idiopathic unless pericarditis or similar.