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Reverse VSD and Eisenmenger’s syndrome

Case Study

Case Study

Reverse VSD and Eisenmenger’s syndrome

An 8-week-old female Silky Terrier was presented for evaluation of dyspnea and diarrhea. No murmur was auscultated on physical examination. Parvo snap test was negative and hematocrit was 28%. Survey radiographs show right-sided cardiomegaly, focal area of pulmonary consolidation, and an enlarged PA.

An 8-week-old female Silky Terrier was presented for evaluation of dyspnea and diarrhea. No murmur was auscultated on physical examination. Parvo snap test was negative and hematocrit was 28%. Survey radiographs show right-sided cardiomegaly, focal area of pulmonary consolidation, and an enlarged PA.

Sonographic Differential Diagnosis

Pulmonary Hypertension – suspected, severe based on presumed TR velocity, degree of LV underloading/pseudohypertrophy and RV concentric hypertrophy
2.) Suggestive for reverse VSD and Eisenmenger’s syndrome

Image Interpretation

The left ventricular chamber is small with hypertrophied walls, suggestive of volume underload. There is adequate LV function. There is severe dilation and concentric hypertrophy of the RV, subjectively. There is severe RA dilation. The LA is small/normal in size (La:Ao 1.24). The main pulmonary artery is severely enlarged and there appears to gross changes to the branching pulmonary arteries, suggestive of a PDA. There is normal, laminar flow across the PA (0.75m/s). There is high velocity, turbulent systolic flow associated with the septal aspect of the TV that appears to be TR. However, I cannot rule out a VSD. The velocity of flow is high velocity (3.91-6.25m/s). No effusions visualized. LVIDd – 0.91cm FS – ~50%

DX

Reverse VSD and Eisenmenger's syndrome

Clinical Differential Diagnosis

Lung – pneumonia, edema, atelectasis, hemorrhage, abscess, granuloma
Cardiomegaly – tricuspid dysplasia, atrial/septal defect, pulmonic stenosis, Tetralogy of Fallot

Sampling

None

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Patient Information

Patient Name : Baley K
Gender : Female, Intact
Species : Canine
Type of Imaging : Ultrasound
Status : For Review
Liz Wuz Here : Yes
Code : 15-00201

Clinical Signs

  • Diarrhea
  • Dyspnea

Images

img_9595img_9597baley_katz_reverse_pda_r_to_lbaley_katz_reverse_vsd_epssbaley_katz_reverse_vsd_lvbaley_katz_reverse_vsd_pabaley_katz_reverse_vsdscreen_shot_2014-11-14_at_11

CBC

  • Hematocrit, Low

Clinical Signs

  • Diarrhea
  • Dyspnea