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Radiology Packet 7

Radiology Packet 7. Congenital cardiac disease. 8-month old Saint Bernard “Ben”. Hx: Cardiac murmur first noted when the puppy was 6 weeks old and is described as a grade 3 of 4. The murmur is predominantly right sided but does radiate to the left. 8-month old Saint Bernard “Ben”. RF

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Radiology Packet 7

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  1. Radiology Packet 7 Congenital cardiac disease

  2. 8-month old Saint Bernard “Ben” • Hx: Cardiac murmur first noted when the puppy was 6 weeks old and is described as a grade 3 of 4. The murmur is predominantly right sided but does radiate to the left.

  3. 8-month old Saint Bernard “Ben” • RF • In the lateral view the caudal border of the heart is long and straight and there is elevation of the caudal mainstem bronchi. • In the VD view the right ventricle appears rounded and in the lateral view there is increased sternal contact. • In the lateral view there is a loss of the cranial cardiac waist. • In the VD view there is enlargement of the aortic arch and descending aorta. • There is generalized increase in the size and number of pulmonary vessels. • RD • Severe generalized cardiomegaly • Increased prominence of the aortic arch and descending aorta • Vascular lung pattern • R/O • PDA • VSD • ASD • Next • Echocardiography

  4. 16-month old Jack Russell Terrier“Bandit” • Hx: Presented for exercise intolerance and polycythemia (PCV 60-75%)

  5. 16-month old Jack Russell Terrier “Bandit” • RF • In the lateral view the heart is ~4 ICS wide and the VHS is 10.7 on the Buchanan scale. • The heart is widened and there is increased sternal contact. • Loss of the cranial cardiac waist. • In the VD view the heart has a “reverse D” appearance. • There is a prominent bulge at 1-2 o’clock indicating enlargement of the main pulmonary artery. • There is a bulge in the aortic arch at the same level as the pulmonary artery bulge. • RD • Right ventricular enlargement • R/O • Pulmonic stenosis • Right-to-left PDA • Heartworm disease

  6. 10-month old Domestic Long Hair“Kristen” • Hx: Presented for routine overiohysterectomy. During PE a grade 6 of 6 systolic murmur was ausculted.

  7. 10-month old Domestic Long Hair“Kristen” • RF • In the lateral view there is increased width and increased length of the cardiac silhouette. • The cranial and caudal pulmonary vessels are enlarged. • RD • There is generalized cardiomegaly with over-circulation of the lung fields • R/O • VSD • PDA • Next • Echocardiogram or angiogram (we do not normally diagnose VSD’s on rads)

  8. 3.5-month old Brittany Spaniel“Nel” • Hx: Clinically normal but is noted to have a continuous heart murmur that is grade 5 of 6.

  9. 3.5-month old Brittany Spaniel“Nel” • RF • Elongation of the caudal heart border as well as elevation of the mainstem bronchi. • In the lateral view a soft-tissue opacity structure with a straight caudal edge is noted in the left atrial region and in the VD view there is mild spreading of the mainstem bronchi. • In the VD view a bulge of the aorta can be seen adjacent to the main pulmonary artery region, known as a “ductus bulge”. • A small bulge is also present in the region of the main pulmonary artery. • Cranial and caudal pulmonary arteries and veins are slightly enlarged and there appear to be many more small vessels than are usually seen. • RD • Enlargement of the L atrium and L ventricle • Pulmonary over-circulation • Enlarged main pulmonary artery • R/O • PDA • Next • Echocardiogram

  10. 7-month old Newfoundland • Hx: Presented with a loud systolic ejection murmur, heard best on the left. There is exercise intolerance noted by the owner and the pup is smaller than his littermates.

  11. 7-month old Newfoundland • RF • Enlarged soft tissue opacity in the cranial heart region, with loss of the cranial cardiac waist. Bermuda triangle area. • On the VD view, the apex of the heart is a bit rounded, the heart looks a little long. • The soft tissue opacity noted on the lateral view is located in the cranial mediastinum at the 12 o’clock position. • RD • Aortic stenosis • Next • Cardiac ultrasound

  12. 9-month old English Springer Spaniel • Hx: Presented for evaluation of a heart murmur. The PE reveals a happy, active dog with a pansystolic murmur best heard at the right 4th intercostal space at the level of the heart base.

  13. 9-month old English Springer Spaniel • RF • Cardiomegaly is present. • In the lateral view the cardiac silhouette is increased in craniocaudal dimension (width) and there is increased sternal contact of the heart. • Elevation of the caudal mainstem bronchi and trachea and straightening of the caudal cardiac waist are present. • RD • Generalized cardiomegaly • R/O • VSD • PDA • Next • Echocardiography

  14. 3 Year Old Wheaton Terrier • Hx: Presented for an intestinal obstruction. The patient has a history of heart disease. Radiographs of the thorax were obtained prior to surgery to correct the intestinal obstruction.

  15. 3 Year Old Wheaton Terrier • RF • In the lateral view, there is widening of the heart base and a slightly square appearance to the cranial cardiac margin. • In the VD view, there is a prominent bulge at the 1-2 o’clock position (left cranial cardiac margin) is considered evidence of main pulmonary artery segment enlargement. • RD • Enlargement of the heart base due to increase size of the main pulmonary artery segment • R/O • Pulmonic stenosis • Patent ductus arteriosus • Heartworm disease

  16. 6-month old Cavalier King Charles Spaniel • Hx: Presented for evaluation of a murmur. The murmur is described as Grade 3 of 6 pansystolic. The point of maximal intensity is on the right side.

  17. 6-month old Cavalier King Charles Spaniel • RF • Cardiac silhouette is enlarged. • In the lateral view the cardiac silhouette is wide and there is increased sternal contact. • In the VD view the most prominent cardiac enlargement is in the region of the right atrium. • RD • Right atrium enlargement • Right ventricular enlargement • R/O • Tricuspid dysplasia

  18. 10-year old MN Doberman Pinscher “Dane” • Hx: Presented for evaluation of ataxia (it is suspected that he is a Wobbler). On PE a grade 1 of 6 murmur is ausculted. The murmur is systolic and is heard best on the left side of the chest. ECG is normal

  19. 10-year old MN Doberman Pinscher “Dane” • RF • The caudal mainstem bronchi are elevated and there is straightening of the caudal cardiac waist. • A tracheospinal angle is still present but the trachea is considered elevated in this deep-chested individual. • In the VD view the cardiac silhouette is rounded. • Diffuse interstitial lung pattern present that is consistent with normal aging change. • Incidental finding of multiple sites of spondylosis in the central thoracic spine. • RD • Moderate generalized cardiac enlargement • R/O • Dilatative cardiomyopathy

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