Transcript Radiology Packet 1 - News, Events, and Publications

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”
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RF
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RD
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Severe generalized cardiomegaly
Increased prominence of the aortic arch and descending aorta
Vascular lung pattern
R/O
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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.
PDA
VSD
ASD
Next
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Echocardiography
16-month old Jack Russell Terrier
“Bandit”
•
Hx: Presented for exercise intolerance and polycythemia (PCV 60-75%)
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
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R/O
– Pulmonic stenosis
– Right-to-left PDA
– Heartworm disease
10-month old Domestic Long Hair
“Kristen”
• Hx: Presented for routine overiohysterectomy. During PE a grade 6
of 6 systolic murmur was ausculted.
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)
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.
3.5-month old Brittany Spaniel
“Nel”
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RF
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RD
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Enlargement of the L atrium and L ventricle
Pulmonary over-circulation
Enlarged main pulmonary artery
R/O
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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.
PDA
Next
–
Echocardiogram
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.
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
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.
9-month old English Springer
Spaniel
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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.
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RD
– Generalized cardiomegaly
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R/O
– VSD
– PDA
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Next
– Echocardiography
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.
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
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.
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
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
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