The echocardiogram for this patient presented a left atrium of excessive size with anechoic content. No evidence of “smoke” or thrombotic activity was noted. The atrial septum was deviated toward the right atrium consistent with left sided overload. The LA/AO ratio was excessive for dogs. The cranial and caudal mitral valve leaflets demonstrated mildly vegetative contour. End point to septal separation was excessive consistent with dilated cardiomyopathy. The left ventricle demonstrated mildly excessive volume, and normal to subnormal septal and free wall diastolic thicknesses. Ventricular function was deemed subnormal expressed by the fractional shortening measurement listed below. The aortic outflow tract revealed direct laminar flow along the ventricular septum with subnormal outflow velocity. Periaortic tissue was uniform and of normal echogenicity. No inconsistencies were revealed regarding the presence of an aortic body tumor or chemodectoma. The right atrium was enlarged. Tricuspid valve insufficiency was noted and was significant at 3.1 m/sec. This is consistent with pulmonary hypertension. The right ventricle demonstrated normal size (1/3 diameter of the left ventricle), morphology, and kinetic activity. No evidence of heartworm or infiltrative disease was noted. The pulmonary artery was dilated. The myocardium throughout the heart was uniformly echogenic without evidence of significant fibrosis, infiltrative disease (lymphoma, hemangiosarcoma) or ischemic events (infarcts). Endo, epi, pericardial and pleural tissue was uniformly hyperechoic to the myocardium without the presence of effusions. Tachyarrhythmia was noted during the exam in this patient. An electrocardiogram would be warranted. Tricuspid insufficiency velocity 3.1 m/sec.