Radiology Packet 4

1. Radiology Packet 4 Cardiac Enlargement

2. 9 year old shetland sheepdog “Alt” • Hx: Presented for coughing, exercise intolerance and has a systolic murmur

4. 9 year old shetland sheepdog “Alt” • RF • Lateral • Elevation of the trachea. • Heart is taller than it should be. • Marked loss of the caudal cardiac waist with soft tissue structure overlying the caudal heart base region. • Upward deviation toward the heart of the caudal vena cava. • Increased cardiophrenic contact. • Prominent pulmonary vessels. • DV • Large soft tissue opacity of the hilar region, between the mainstem bronchi, which can be followed over to the 3 o’clock position (left atrium and auricle). • R/O • Mitral insufficiency and secondary heart enlargement • Next: Cardiac ultrasound

5. 10 year old M German Shepherd “Civa” • Hx: Dog is bradycardic and premature ventricular contractions were noted on ECG

7. 10 year old M German Shepherd “Civa” • RF • Mild generalized cardiac enlargement. • Incidental finding of spondylosis at several sites in the thoracic spine. • R/O • Dilatative cardiomyopathy • Pericardial effusion • Next: ECG

8. 10 year old cocker spaniel MN “Sprocket” • Hx: Presented for evaluation of a chronic cough. No signs of systemic illness and no heart murmur is ausculted. The patient has been treated with Furosemide (Lasix), Enalapril (cardiac drug) and Hycodan (cough suppressent)

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10. 10 year old cocker spaniel MN “Sprocket” • RF • Right ventricular enlargement. • Trachea is mildly elevated so right atrial enlargement may also be present. • Diffuse mild interstitial lung pattern consistent with normal age change. • Liver is mildly enlarged. • R/O • Right sided cardiac enlargement • Cor pulmonale • Aquired right-sided cardiac enlargement (relatively uncommon) • Bronchitis

11. 6 year old FS Bernese Mountain Dog • Hx: Presented for surgical repair of a cranial cruciate ligament rupture. While under general anesthesia occasional ventricular pre-mature contractions were noted.

13. 6 year old FS Bernese Mountain Dog • RF • Microcardia and small size of the pulmonary vessels. • Lung fields are over-exposed making evaluation more difficult • RD • hypovolemia • R/O • Dehydration • Shock • Addison’s disease (hypoadrenocorticism) • Next: ACTH stimulation test

14. 4 year old German Shorthair Pointer “Autumn” • Hx: Has had 2 episodes of mild weakness/collapse associated with intense exercise. A persistent cough is also reported. A systolic murmur with the point of maximal intensity at the aortic valve was noted ~1 year ago.

16. 4 year old German Shorthair Pointer “Autumn” • RD • Mild right-sided cardiac enlargement • Moderate diffuse interstitial lung pattern with bronchial markings (not prominent enough to call a broncho-interstitial lung pattern) • R/O • Tricuspid valve insufficiency • Cor pulmonale (increased size of the right heart due to pulmonary hypertension) • Presence of interstitial pattern is non-specific and R/O include lungworm infestation, interstitial pneumonia and interstitial changes due to prior pulmonary disease • Next: • Echocardiography • Baermann fecal exam

17. 12 year old DSH “Tuffy” • Hx: Presented for mild ataxia. The owners report the cat seems to be breathing rapidly. Auscultation of the thorax was unrewarding.

19. 12 year old DSH “Tuffy” • RF • Increased sternal contact of the heart and the aorta has a prominent appearance. • Cardiac silhouette is wider than normal. • Cranial border is slightly square on the lateral view. • Heart has a “Valentine” shape. • The cranial pulmonary vessels are seen and at the upper limits of normal size. • RD • Hypertrophic cardiomyopathy • Next • Echocardiogram

20. 6-year old MN DSH“Fatty Lumpkin” • Hx: Presented for evaluation of lethargy and increased respiratory rate

22. 6-year old MN DSH“Fatty Lumpkin” • RF • Cardiac silhouette is partially obscured by increased opacity within the thoracic cavity. • The atrial region of the heart appears wide. • The trachea is elevated. • Mild pulmonary vascular congestion is present as well as free pleural fluid. • RD • Hypertrophic cardiomyopathy • Congestive heart failure

23. 9-year old MN Schipperke“Robbie” • Hx: Presented for evaluation of a cardiac murmur. The murmur was not present the previous year. It is described as a grade 2-3 of 6 systolic murmur.

25. 9-year old MN Schipperke“Robbie” • RF • Caudal mainstem bronchi are elevated and there is loss of the caudal cardiac waste. • In VD the left atrium is visible as a large round structure caudal to the mainstem bronchi bifurcation. • The entire trachea is elevated and the caudal cardiac margin is elongated. • In the VD there is mild bulging in the left ventricular region. • RD • Left atrial and ventricular enlargement • R/O • Mitral regurgitation secondary to mitral valve endocardiosis

26. 12 year old M Saluki“Linca” • Hx: Presented with a 1 week history of lethargy and poor appetite. On PE the abdomen appears distended and a fluid wave can be balloted. On auscultation the heart sounds are muffled and of variable intensity.

28. 12 year old M Saluki“Linca” • RF • Cardiac silhouette is enlarged and very round. • In the lateral view a single pleural fissure line is visible. • RD • Globoid cardiac silhouette • Pericardial effusion • R/O • Hemangiosarcoma of the right atrium • Heart base mass (lymphosarcoma) within the pericardial sac • Idiopathic pericardial effusion • Pericardial effusion leading to right sided heart failure • Underlying cardiac disease such as dilated cardiomyopathy and tricuspid dysplasia • Peritoneopericardial diaphragmatic hernia