Case Study

Primary tricuspid valve dysplasia with mild pulmonary hypertension in a 8 year old FS Labrador Retriever dog

The patient, an eight year old female spayed Labrador Retriever was presented for recheck of a previous documented heart defect. Mild panting noted. No current heart medication. Previous diagnosis of hypothyroidism, is on thyroxine; last T4 wnl 1.2.

CBC/Chem: ALKP 238

Urinalysis: protein +3, USPG 1.021, UPC 4.2, UCCR 62 (<32)

CBC/Chem: ALKP 238

Urinalysis: protein +3, USPG 1.021, UPC 4.2, UCCR 62 (<32)

Image Interpretation

Subjective Assessment (B-Mode Findings): Moderate to severe right ventricle enlargement and right atrium enlargement. Thickened Tricuspid Valve consistent with Tricuspid Valve Dysplasia. Moderate Tricuspid Valve regurgitation on Color Flow Doppler. Normal appearance to left atrium and left ventricle. Mild Pulmonic Valve insufficiency on Color Flow Doppler. No masses or effusion.

M-Mode Measurements (cm):

IVSd- 1.04 (1.11-1.28) IVSs- 1.49 (1.7-1.89)
LVIDd- 3.69 (3.46-4.64) LVIDs- 1.89 (2.06-3.08)
LVPWd- 1.04 (0.9-1.04) LVPWs- 1.71 (1.45-1.62)
FS- 48% (33-46) EPSS- 0.26 (0.03-0.77)
LA- 2.3 (2.36-3.9) HR- 108
Aorta- 1.94 (1.87-3.24) LA/Aorta Ratio- 1.2 (0.8-1.3)
LVOT: 1.8 m/s (1-2 m/s)
RVOT: 1.1 m/s (<1.5 m/s) TV insufficiency vel: 3.3 m/s

DX

Primary tricuspid valve dysplasia with mild pulmonary hypertension

Outcome

Moderate right ventricle and right atrium enlargement (right side overload) which is compensated at this time, no signs of right heart failure including ascites or hepatic vein dilation. The TV insufficiency velocity (pressure gradient approx. 43 mmHg) is consistent with mild pulmonary hypertension. Anatomically and functionally normal left heart. Based on current echo findings at this time, the heart appears stable and no treatment is suggested at this time. Monitoring for exercise intolerance on walks, climbing stairs, etc is suggested. ECG may be monitored as atrial fibrillation can be seen with right atria enlargement.
Recommend recheck in 6 months unless excercise intolerance is noted.