Case Study

15-00220 Thunder G Heartbase mass with caval obstruction, MI, TI, arrhythmia

An 8-year-old NM English Bulldog was presented for evaluation of acute ascites and a murmur.

Sonographic Differential Diagnosis

Heart base mass obstructing vena cava inflow.
Concurrent mitral and tricuspid insufficiency and arrhythmia. No volume overload of the heart. The mass is causing a parenchymal cardiomegaly.
Trace pericardial effusion was noted.
Pulmonary hypertension.
Enlarged adrenal glands.
Given the breed predisposition chemodectoma, fibrosarcoma or possible hemangiosarcoma are all potentials. However, hemangiosarcoma is the lowest on the list given the position of the mass. Blood pressure measurements and supportive therapy as well as an abdominocentesis would all be warranted. No specific cardiac medications are recommended unless arrhythmogenic activity is to be treated. A Holter monitor would be optimal for that purpose.

Image Interpretation

The cardiac presentation in this patient included a heart base mass. The mass was solid and measured at least 5.4 cm, but extended further caudally out of view and obstructed the vena cava inflow. The LA:AO was falsified as the mass occupied the left atrium. The right atrium was mildly enlarged. Arrhythmogenic activity was noted. Hypocontractility was noted. Given the position of the mass and the breed, aortic body tumor is likely. Mitral and tricuspid insufficiency was noted. The mass encompassed the heart base obstructing the vena cava inflow and deviating the aorta. No pericardial effusion was noted.