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– 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

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

• 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”

• 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

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

• 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

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