A 6-month-old M Shih Tzu was presented for initial puppy visit. On physical examination, a grade III/VI heart murmur was present on auscultation.
A 6-month-old M Shih Tzu was presented for initial puppy visit. On physical examination, a grade III/VI heart murmur was present on auscultation.
Pulmonic stenosis with infundibular hypertrophy
Thickened dynamic right ventricular outflow obstruction prior to the pulmonic valve was noted. The pulmonic valve was thickened with mild insufficiency and severe excessive outflow velocity. Post valvular pulmonary artery dilation was noted at the bifurcation (Video 1). There was also severe, right ventricular hypertrophy with dynamic obstruction (Video 2). The right ventricle demonstrated concentric hypertrophy that impinged upon the tricuspid valve. Mild tricuspid insufficiency was noted, with mild right atrial prominence. Pulmonic insufficiency velocity was 2.4 m/sec.The left ventricle was largely normal. However, some septal bowing into the left ventricle was noted.
The patient was referred to an interventional cardiology facility for possible balloon valvuloplasty or other interventional procedure. The long term prognosis for this patient was regarded as poor.
Congenital heart disease – valve stenosis (mitral, aortic, pulmonic), ASD, VSD
None taken.
