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Presentation Transcript
Rudy the Labrador CardioRush
Presentation 4 month old male Lab Complaint: Owner noted a markedly increased heart rate. Rudy is quieter than normal and has mild shortness of breath with an occasional cough. There is no known heart disease in his littermates. CardioRush
Physical Exam Heart Murmur: When HR is slow, a 4/6 holosystolic plateau-shaped murmur is heard at the left heart apex; a 3/6 murmur is also heard at the right mid-cardiac region Gallop: S3 HR= 300 to 140/min Arterial pulses-weak with pulsus alternans during fast HR Respiratory Mild increase in RR +/- effort; normal BV sounds CardioRush
ECG at 25mm/sec CardioRush
Thoracic Radiographs CardioRush
Assessment What is this patient s heart rate and rhythm based on the ECG? What is your radiographic interpretation? Answers on next page CardioRush
Assessment What is this patient s heart rate and rhythm based on the ECG? About 320bpm, supraventricular tachycardia What is your radiographic interpretation? There is cardiomegaly with a perihilar interstitial pattern, LA enlargement, and ECG leads on the chest. CardioRush
Echocardiogram CardioRush
Diagnosis What type of heart disease does Rudy have? What is the cause of Rudy s tachycardia? Does the murmur location and timing fit with this disease process? Answers on next page CardioRush
Diagnosis What type of heart disease does Rudy have? Supraventricular tachycardia (SVT), mitral regurgitation with left ventricular and left atrial enlargement What is the cause of Rudy s tachycardia? SVT can develop as a result of significant underlying heart disease, or it can result from a congenital problem, such as a bypass pathway (Wolf- Parkinson-White, or WPW syndrome). Labrador retrievers are know to have an inherited tendency to have these bypass pathways. Does the murmur location and timing fit with this disease process? Yes, a holosystolic left apical murmur is typical for mitral regurgitation, which was also present in this case. CardioRush
What is your treatment plan? CardioRush
Some Possible Treatment Options Calcium channel blockers (diltiazem or verapamil) Beta-blockers Digoxin Amiodarone Ablation of the suspected accessory pathway CardioRush
