This is a 2 y 8m old, FN DSH cat presented with pleural effusion and dyspnoea.
Echo shows LA:Ao ratio of 1.9 approx and there is a 7mm thrombus in LA. There is IVS diastolic increased thickness as well as post wall, too. (8mm and 6.7mm respectively). My doppler cannot really read and kitty did not tolerate exam to position her on left parasternal for left apical view and more extensive measurements.
This is a 2 y 8m old, FN DSH cat presented with pleural effusion and dyspnoea.
Echo shows LA:Ao ratio of 1.9 approx and there is a 7mm thrombus in LA. There is IVS diastolic increased thickness as well as post wall, too. (8mm and 6.7mm respectively). My doppler cannot really read and kitty did not tolerate exam to position her on left parasternal for left apical view and more extensive measurements.
It appears to me like Aorta is kind of small in diameter (6.2-6.5 depending on the angle in short axis view) but PA root dimeter is 7.2 and my question is whether there is a possibility of aortic stenosis. I do not see post valvular dilation… any input?
Also, SAM? I always struggle to see whether there is SAM or not.
I assume prognosis is poor considering the thrombus in LA…
Thanks for any input.
Comments
To me the septum and VFW are
To me the septum and VFW are thickened. The septum appears to bulge into the outflow tract causing an obstruction. Not SAS but rather a functional obstruction from the IVS. In the first cine it does appear that there is SAM. Flow into and out of the L atrium has to be poor for a clot to form.
Ok – I am committed. Lets wait and see what others say.
Looks like smoke in the LA,
Looks like smoke in the LA, subjectively looks like SAM as well. Plavix acei lasix and cage rest for now i would think and keep body temp > 98 F checling pulse quality brachial and femoral.
Here is a case of the month peter and I did a while back on Sam I Am:)
http://sonopath.com/resources/cases-month?page=5
Im not sure who has the stranger sense of humor Peter or I:)
Thanks guys for the input.
Thanks guys for the input. So… Basically, no aortic stenosis… I just wanted to check the reality of that aortic root measurement. Did I get it wrong? Or it is possible that cat has a smaller aorta but still normal? In all references the usual aortic root diameter is around 9mm… This cat has 6.2-6.5
I also thought that the obstruction in LVoT was more septum rather than valve. Thanks for the input!!
Subjectively I don’t see
Subjectively I don’t see anything wrong with the AV but i do see some septal impingement on the pre av area.. typical of hcm. Be sure when you measure the aortic root that the Ao is at its widest point and you are at the AV where the aorta dilates just a bit. Eyeballing that on your first video it looks like about 0.9 cm or so and your video is just a bit off line with the lvot as the AV isnt exactly in the middle of the AO which is where you would make that measurement. If you slide slightly more dorsally toward the spine and drop the probe tail at that point the AV will be in the middle of the AO and the Ao will be at its maximal width. I think if you do that then the AO root will be normal like the mmode attached. Also you would need spectral doppler of the lvot in apical position and have a very high lvot velocity in sas but also get that in fixed lvot obstruction in hcm as well.