Enlarged heart

RE: Enlarged heart

David Mills — Thu, 13 Dec 2018 23:36:07 GMT

Hypertrophy is unusual in any dog unless there is some obstruction to aortic flow (e.g. Aortic stenosis, hypertension), or in the case of the right ventricle, pulmonary hypertension. A congenital defect in this dog would be unusual.

I don't think the scan is diagnostic on this picture. The heart is not excessively enlarged, but radiography is not particularly sensitive for this unless it is massive. A scan with attention to left atrial size and some measure of contractility is key.

Dcm is always a concern in springers.

RE: Enlarged heart

Sarah Keir — Thu, 13 Dec 2018 16:54:31 GMT

I am not a cardiologist but here are my tuppence:

- you have a pupillary muscle on the left and cordae on the right so you are not in a true transverse of the left ventricle. Therefore as you are measuring at an angle through the interventricular septum, you will artificially increase the measurement you get.

- the cursors are not on the edge of the muscle on either side so this is probably increasing the number you are getting.

- what point of the cardiac cycle was the image frozen? Is it full diastole?

- what is the body weight of this spaniel?

You can look up normal measurements e.g. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2004.tb02551.x

RE: Enlarged heart

Claire Godfrey — Thu, 13 Dec 2018 15:51:25 GMT

[quote user="Julie Innes"]

As I said, not great with echo, but is there something in your ventricular lumen there, or is that normal?

[/quote]

I was assuming this was the chordae tendineae, seemed to correlate when the scan was not frozen.

RE: Enlarged heart

Martin Atkinson — Thu, 13 Dec 2018 12:11:07 GMT

[quote user="Kate Richardson"]

From memory, springers can get DCM

[/quote]You wouldn't get thickened ventricular walls with that though would you? and as far as I can measure VHS is 10.5. This is probably within a margin of error (normal 9.5) and with DCM would expect it to be much greater.

You could perform an NT-proBNP, that would give you some guidance before just referring.

RE: Enlarged heart

Kate Richardson — Thu, 13 Dec 2018 11:58:59 GMT

From memory, springers can get DCM so I would be suspicious and would adv a cardiologist referral. Or trial on vetmedin?

RE: Enlarged heart

Julie Innes — Thu, 13 Dec 2018 08:56:59 GMT

As I said, not great with echo, but is there something in your ventricular lumen there, or is that normal?

RE: Enlarged heart

Julie Innes — Thu, 13 Dec 2018 08:55:24 GMT

I was told that springer spaniels do have big hearts radiographically, compared to other breeds. I confess to not being confident with echo measurements, but looks fairly normal from the radiograph, I think. Any murmur/ cough?

RE: Enlarged heart

Beats — Wed, 12 Dec 2018 18:58:01 GMT

I'll stick my neck out and say that I think there is not left atrial enlargement (nor congestion of cranial pulmonary vein) and as such does not have left-sided congestive heart failure as cause of clinical signs.

I'm not at all confident in my ability to interpret chest films however.....

RE: Enlarged heart

Sarah Keir — Wed, 12 Dec 2018 17:52:34 GMT

There is a fair amount of rotation on the lateral thoracic xray so assessment of cardiac shape and size will compromised by this.