Today’s case is a 5 month old female Shih Tzu with a heart murmur. What is your top differential diagnosis?
Teaching and learning about veterinary diagnostic imaging.
Today’s case is a 5 month old female Shih Tzu with a heart murmur. What is your top differential diagnosis?
The cardiac silhouette is moderately enlarged, with a bulge in the region of the main pulmonary artery on the dorsoventral projection. There is a vascular pattern with diffusely enlarged pulmonary vasculature throughout the pulmonary parenchyma. No other abnormalities are noted in the pleural space, mediastinum, or musculoskeletal structures. The portion of the abdomen included is normal.
Congenital cardiac anomaly – patent ductus arteriosus.
The vascular pattern and cardiac enlargement indicate a left to right shunt, and the bulge in the main pulmonary artery is characteristic of a PDA. Because of the dog’s small size (1.6 kg), coiling was not an option. The PDA was surgically ligated successfully.
bruceduncan says
It is clear to me that the heart is moderately enlarged and that there is a bulge in the pulmonary artery, but it also looks to me as though there is some left atrial tenting, is this the case?
Charlierak says
This may not be an answer that you are looking for. In a case of the left atrial tenting, should we see some elevation of the left main-stem bronchus on lateral projection with bowed main-stem bronchi on DV view?