Case Study

Tricuspid valve dysplasia with secondary pulmonary hypertension in a 4 year old MN German Shepherd dog

A 4 1/2 year old MN German Shepherd dog presented for a grade IV/VI holosystolic heart murmur and several episodes of collapse that have lasted approximately 36 seconds in duration. Owner reports no evidence of seizures or signs consistent with seizure activity. The patient recovers quickly but does not appear completely conscious.

A 4 1/2 year old MN German Shepherd dog presented for a grade IV/VI holosystolic heart murmur and several episodes of collapse that have lasted approximately 36 seconds in duration. Owner reports no evidence of seizures or signs consistent with seizure activity. The patient recovers quickly but does not appear completely conscious.

Sonographic Differential Diagnosis

Tricuspid valve dysplasia, secondary pulmonary hypertension, minor potential for non-visible reverse PDA.

Image Interpretation

Subjective assessment of the right atrium and auricle revealed right atrial enlargement. The tricuspid valve presented with a short, stubby, nodular septal wall leaflet and a long free wall leaflet. Tricuspid valve insufficiency was seen with a jet of 7.01 m/sec. The right ventricle was of normal size (1/3 diameter of LV), echogenicity and thickness. No evidence of dilation nor restriction was noted. Suspected arrhythmia.

DX

Tricsupid valve dysplasia with secondary pulmonary hypertension

Outcome

Recommend BP and ECG. Recommend referral to cardiologist or repeat echo to re-evaluate pulmonic valve and RVOT. Reverse PDA not seen but could be present; can investigate through a bubble study on ultrasound.If reverse PDA present then treatment for pulmonary hypertension could be contraindicated.