When to start Diuretics/Pimopendan

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When to start Diuretics/Pimopendan

I recently did an echo on Bella.

Bella is a 12 year old Maltese that weighs just over 8 pounds

Grade 4/6 mitral regurgitation and 2/6 Tricuspid regurgitaion

Chest X-rays: cardiomegally with dilated L atrium. No indication of pulmoary edema. Collapse/compression of the L main stem bronchus. Historical cough

Echo findings:

I recently did an echo on Bella.

Bella is a 12 year old Maltese that weighs just over 8 pounds

Grade 4/6 mitral regurgitation and 2/6 Tricuspid regurgitaion

Chest X-rays: cardiomegally with dilated L atrium. No indication of pulmoary edema. Collapse/compression of the L main stem bronchus. Historical cough

Echo findings:

2D: Subjectively the wall thickness of the IVS and VFW appar to be normal. The L vetnricluar chamber is dilated as would be expected with mitral valve disease. The L atrium is dilated. The R side of the heart looks to be WNL.

 CFI: only done on the MI. Reveals a large mitral regurgitant jet.

 M mode: all values in mm

 IVSd:  6.2   (5.7-7.6)

LV chamber d:  30.7  (17-19.2)

LVWd: 6.2  (4.6-6.1)

IVSs:  12.8 (8.6-10.7)

LV chamber s: 11.7  (9.2-11.2)

LVWs: 11.7 (7.7-9.6)

FS: 62

 Aorta:  13.1

L Atrium 16.6

 LA/AO: 1.3  (0.8-1.1)

 EPSS: 4.1

 IVSd/LVIDd 0.2 (.22-.34)

 LVIDd/ LVPWd  5.0   (>3 < 5)

 2D measurements:

 Aorta 11.4

L Atrium  23.8

 LA/AO: 2.1  < 1.6

Doppler: (m/sec)

Aorta: I could not get this reading

Pulmonary: 1.1

Tricuspid regurgitation: 2.7

Mitral Regurgitation: 5.6

 

Echocardiographic summary:

1. Normal wall thickness. This is of some concern. The normal response to chamber dilation would be concentric hypertrophy

2. Dilated L ventricular chamber in both diastole and systole consistent with a volume overload.

3. Dilated LA in both M mode and 2D consistent with mitral regurgitation and volume overload

4. Tricuspid regurgitation consistent with mild pulmonary hypertension

5. Good compensatory FS

 

At this time I believe that Bella is not in CHF and is compensating OK.

The big ?- when do we start a diuretic and Pimobendan.

 

I will submit this ? to Sonopath 

 

 

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