Suspected Left Atrial Rupture In A 14-Year-Old MN Maltese: Our Case of the Month August 2017
With a mitral regurgitation that is banging against the left atrium with every contraction day in and day out, over time - something's gotta give! Pericardial effusion in light of severe valvular disease, think left atrial tear before tumor. Many thanks to Dr. Scott Martens from Hamburg Veterinary Clinic for providing the images for this case and kudos to technician, John Kollbocker on his excellent scanning.
Join us at our next SDEP Echo Lab in Denver, CO October 13-15 to learn how to obtain images like these and get up-to-date on the pathology we are seeing in cardiology by Mandi Kleman, DVM, DACVIM!
A 14-year-old, MN, 13.5 lb Maltese was presented for a possible syncopal episode after going upstairs and breathing heavier. The patient was treated with enalapril 2.5 mgs PO SID and scheduled for an echocardiogram. Physical Exam: Grade 4/5 murmur. Radiograph indciated severe cardiomegaly. BP 117/74 Map 90. CBC: Normal. Chemistry: Alk. Phos 1340.
Pericardial effusion was noted in this patient. Mild to moderate volume overload of the left atrium and left ventricle was noted with a prolapsing mitral valve. Irregularity of the left atrium was noted which would suggest a tear of the left atrial wall. Prolapse of the mitral valve was noted with vegetative changes. Pulmonary hypertension was present with the tricuspid insufficiency at 3.76 m/sec. Mitral insufficiency was noted at 5.8 m/sec. One particular view at the heart base in this patient revealed chronically enlarged and irregular left auricle with 2 cm echogenic structure at the base of the heart. This may be blood clot or possible mass. The echotexture would be most consistent with an attached blood clot. Mild hepatic vein dilation was noted in this patient. Vena cava measured approximately 1 cm at the diaphragmatic inlet.