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  Case Study 3: Pulmonic Stenosis Mild
 

Signalment: Border Terrier, 6 years old, male

History: Heart murmur was heard by the referring Vet during a routine examination. The owner never registered any symptoms

Clinical examination: Systolic heart murmur over the left heart base 2/6,; pulse, capillary refill time, respiration normal. sinus rhythm on ECG without any axis deviation.

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  Video 1  
 

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  Images 1 & 2, Video 1: 2D-Echocardiography: Mild right ventricular concentric hypertrophy, pulmonic valve thickened and somehow immobile. AV-Valves without any abnormalities, left ventricle and aortic valve without pathologic findings
   
 
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Image 3: Colour flow Doppler: Systolic turbulence starting at the pulmonic valve and extending into the pulmonary artery. Mild pulmonic insufficiency. Mild tricuspid regurgitation
   
 
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Images 4 & 5: Spectral Doppler: Assymmetric flow profile (acceleration time shorter) and high peak velocity on CW-Doppler across the left ventricular outflow tract and pulmonic valve (3,27 m/s, pressure gradient 43 mm Hg).  A considerable pulmonic insufficiency is also detected. PW-Doppler reveals  peak velocity and turbulence at the level of and slightly behind the pulmonic valve.

Diagnosis:  Mild valvular pulmonic stenosis

Therapy: none
   
 
 
 
 
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