A 13-year-old SF Westie was presented for evaluation of slight respiratory difficulty. Survey radiographs showed pronounced right-sided cardiomegaly.
A 13-year-old SF Westie was presented for evaluation of slight respiratory difficulty. Survey radiographs showed pronounced right-sided cardiomegaly.
Marked left and right ventricular concentric hypertrophy. Possible dynamic onstruction of the LVOT. Possible pulmonary hypertension. Mild DMVD and mitral insufficiency. No sign of congestion. Based on these findings I would not give any medication. The pulmonary hypertension could be treated with Pimobendan as first line therapeutic agent but this could cause worsening of the dynamic obstruction of the LVOT. In case the lung pattern shows evidence of severe pulmonary fibrosis and clinical symptoms become worse one could try low dose sildenafil (1 mg/kg sid). Propentophylline would also be possible in this patient and would not cause any risk.
Marked left ventricular concentric hypertrophy (possibly at least partly pseudo hypertrophy due to dehydration?), a normal left atrium, right ventricular concentric hypertrophy and a normal right atrium. There is mild to moderate mitral valve degeneration and -insufficiency present. Flow velocity across the LVOT is ~2m/s and somehow dagger shaped indicating possible dynamic obstruction of the LVOT which could be another cause for left sided concentric hypertrophy. The pulmonary artery looks slightly broadened in the absence of enhanced velocity across the RVOT. This could be due to pulmonary hypertension, which could also cause the right ventricular concentric hypertrophy present in this case.
Please add to title and dx fields additional things you feel are important. Too much to fit; you`ll need to be creative.
Cardiac – tricuspid valve endocardiosis, vegetative endocarditis, right ventricular cardiomyopathy, pericardial effusion, neoplasia Pulmonary hypertension – idiopathic, La pathology (mitral valve endocardiosis, neoplasia, embolism), fibrosis, heartworm disease, thrombo-embolic disease
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