An 11-month-old NM GSD with a history of severe sub-aortic stenosis without left atrial enlargement was presented for evaluation of recent onset listlessness and exercise intolerance.
Case Study
15-00225 Niu Niu C SAS, LAE, CHF
Sonographic Differential Diagnosis
1.) Subaortic Stenosis – severe
2.) Myocardial failure
3.) Left atrial enlargement – severe
4.) CHF – suspected based on clinical signs
Image Interpretation
The left ventricle measures severely enlarged with myocardial failure. There is adequate systolic function. There is mild to moderate LV concentric hypertrophy diffusely. The left atrium is severely enlarged (La:Ao >1.80). The visible right heart is normal in size, subjectively. Color Doppler identifies high velocity flow associated with the LVOT/AV. The peak velocity of aortic outflow is consistent with at least moderate SAS (LVOT 4.20m/s). There is normal, laminar flow across the RVOT/PV. There is mild MR, AI, and physiologic to mild TR. No effusions or masses visualized. There is a sinus rhythm with an apparent LBBB with average HR of 150bpm.
IVDd – 1.27cm
LVIDd – 5.48cm
LVFWd – 1.37cm
IVDs – 1.70cm
LVIDs – 4.01cm
LVFWs – 1.75cm
FS – 27%
DX
SAS, LAE, CHF
Outcome
None
Clinical Differential Diagnosis
Progressive aortic stenosis with myocardial failure
Vegetative endocarditis
Sampling
None
Video
Patient Information
Gender :
Male, Neutered
Species :
Canine
Type of Imaging : Ultrasound
Status :
For Review
Clinical Signs
- Exercise intolerance
- Lethargy
Images
Clinical Signs
- Exercise intolerance
- Lethargy