May 23, 2013

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Consensus Statement: Treatment of Uncomplicated Canine CHF due to DCM or Endocardiosis
Radiograph Contents   [Introduction]   [Answer]  
   

 
Signalment: 5 months, Female, Ibizan Hound
Presenting Complaint: Murmur evaluation and exercise intolerance (two weeks).
Presenting History

The owners report no vomitting or diarrhea, and that she is able to sleep throughout the night, mainly on her side. The owners also report that she is drinking and urinating frequently and has a history of bladder infections. She is apparently smaller than the rest of her litter-mates. The dog had no apparent difficulty breathing and is not currently taking any medications.

Radiographs


Lateral view


DV view

       
    Radiograph Summary 

Lateral View:
  Evidence of Chamber Enlargement learn more
  Left Ventricle: No    
  Right Ventricle: Yes    3 ICS for a deep chested dog.
  Left Atrium: No    
  Right Atrium: Indeterminate    Cannot assess in this view.
  Left Auricle: Indeterminate    Cannot assess in this view.
  Right Auricle: No    
  Abnormalities of Great Vessels learn more
  Aortic Dilation: Yes    But possibly the MPA.
  Main Pulmonary Artery Dilation: Yes    But possibly the ascending aorta.
  Caudal Vena Caval Enlargement: No    
  Pulmonary Venous Distention learn more: No    
  Airway Changes learn more
  Peribronchial Pattern: No    
  Alveolar Changes learn more
  Air Bronchograms: No    
  Cotton-like Densities: No    
  Lobar Sign: No    
  Pleural Effusion learn more
  Fissure Lines: No    
  Leafing of Lung Lobes: No    
  Pulmonary Edema learn more: Yes    Very prominent.
  Evidence of Heartworm Disease learn more: Yes    Possibly.
  Other Findings
  None 
  Radiographic Diagnosis
  Pulmonic Stenosis 
  Description
  Very prominent MPA and pulmonary arteries. There is no pulmonary artery truncation and/or tortuosity typical of heartworm disease.  
             
DV View:
  Evidence of Chamber Enlargement learn more
  Heart too Wide: Yes    
  Left Ventricle: No    
  Right Ventricle: Yes    
  Left Atrium: No    
  Right Atrium: No    
  Left Auricle: No    
  Right Auricle: Indeterminate    Cannot assess in this view.
  Abnormalities of Great Vessels learn more
  Aortic Dilation: No    
  Main Pulmonary Artery Dilation: Yes    
  Caudal Vena Caval Enlargement: Indeterminate    Cannot assess.
  Pulmonary Venous Distention learn more: No    
  Airway Changes learn more
  Peribronchial Pattern: No    
  Alveolar Changes learn more
  Air Bronchograms: No    
  Cotton-like Densities: No    
  Lobar Sign: No    
  Pleural Effusion learn more
  Fissure Lines: No    
  Leafing of Lung Lobes: No    
  Pulmonary Edema learn more: No    
  Evidence of Heartworm Disease learn more: Yes    Possibly.
  Other Findings
  None 
  Radiographic Diagnosis
  Pulmonic Stenosis 
  Description
  There is a prominent bulge in the area of the MPA. There is no pulmonary artery truncation and/or tortuosity typical of heartworm disease. 
             

Clinical Diagnosis   Pulmonic Stenosis

Comment   This dog had moderately severe stenosis of the pulmonic valve. The pressure gradient across the valve as determined by spectral Doppler was 120mmHg. For this degree of stenosis the magnitude of MPA dilation, and dilation in the pulmonary artery branches is very striking.