This is a 13-year-old male neutered Pug presented for exercise intolerance, and progressive bouts of syncopal episodes during exertion. General scanning revealed a heart with a moderate degree of pericardial effusion. Diastolic collapse of the right atrium was observed. The left atrium appeared slightly smaller than the right atrium in the apical views. There was a mild degree of septal flattening noted with breathing. The mitral inflow E wave could be seen to vary with inspiration. Left ventricular contractility appeared adequate. Both Aortic and pulmonic flow were slightly below normal. Examination of the liver parenchyma revealed mild passive hepatic vein congestion. The gall bladder wall was mildly thickened (2mm). In an obliqued left parasternal long axis view, at the level of the ascending portion of the aorta, a slightly thickened area extending off of the Aortic wall and into the pericardial space/effusion was noted. The tissue was heterogenous in echotexture, sitting close to the right auricle, Aorta and pericardium. Could this possibly represent some epicardial fat or more likely a potential heart base mass( chemodectoma is common in brachycephalic breeds).

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