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Membranous ventricular septal defect (VSD) in a 2 month old FI French Bulldog

Case Study

Membranous ventricular septal defect (VSD) in a 2 month old FI French Bulldog

An 8-week-old intact female French Bulldog was presented for initial visit. A grade III-IV heart murmur was present on physical examination.

An 8-week-old intact female French Bulldog was presented for initial visit. A grade III-IV heart murmur was present on physical examination.

Sonographic Differential Diagnosis

Membranous ventricular septal defect, clinically compensated at this time.

Image Interpretation

The left ventricle presented normal internal volume with adequate contractility, but the membranous septum presented a defect with a left to right turbulent flow and a velocity of approximately 6 m/s. This defect is most consistent with a ventricular septal defect. The defect was confirmed in a 5 chamber right parasternal long axis (Videos 1-3) and also in right parasternal short axis heart base view (Video 4). Normal chamber sizes and contractility suggest that the defect is clinically compensated at this time. The tricuspid valve was found to be linear with proper extension, length and closure. There was no evidence of tethering, length disparity, or vegetation of the leaflets which would indicate dysplastic morphology. Color flow and pulse wave Doppler assessment of the tricuspid valve revealed adequate laminar flow without hemodynamically significant regurgitation or excessive velocity. The right ventricle demonstrated normal size (1/3 diameter of the left ventricle), morphology, and kinetic activity.

DX

Membranous ventricular septal defect, clinically compensated.

Outcome

A recheck ultrasound was recommended for this patient in 4-5 months.

Comments

Often, in small ventricular septal defects, the membranous septum appears only to demonstrate a lack of curvilinear detail and appears a bit irregular. However, when color Doppler is applied, the defect is revealed, as in this case.

Clinical Differential Diagnosis

Congenital cardiac defect (pulmonic valve, atrial/septal defect, PDA), physiological murmur.

Sampling

None taken.

Video

Patient Information

Patient Name : Brooklyn C
Gender : Female, Intact
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 15_00002

Exam Finding

  • Heart Murmur

Images

MembranousVSDShortAxisVSDColorPWDopplerofVSD