Radiology Packet 5

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Radiology Packet 5

• Heart Failure

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8 year Schipperke Robbie

• Hx Has a history of coughing and lethargy. A
  very loud systolic murmur is present, loudest
  over the apex of the heart on the left.

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8 year Schipperke Robbie

• RF
• Heart is too tall and too wide.
• Straightening of the caudal cardiac waist,
  lateral deviation of the right caudal mainstem
  bronchus on the DV view and increased opacity of
  the hilar region on DV.
• Enlarged right cranial lobar pulmonary vein
  relative to the artery.
• Consolidating infiltrates are present in the
  right and left caudal lungs centrally, while the
  periphery (caudal dorsal) is an interstitial
  infiltrate. Air bronchograms are noted in
  consolidated regions (Alveolar pattern).
• RD
• Cardiogenic pulmonary edema
• Chronic left heart failure secondary to mitral
  valve insufficiency

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6-year old MN DSHFatty Lumpkin

• Hx Presented for evaluation of lethargy and
  increased respiratory rate

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6-year old MN DSHFatty Lumpkin

• RF
• Cardiac silhouette is partially obscured by
  increased opacity within the thoracic cavity.
• The atrial region of the heart appears wide.
• The trachea is elevated.
• Retraction of the lung lobes from the thoracic
  wall.
• Mild pulmonary vascular congestion is present as
  well as free pleural fluid (hard to see).
• RD
• Hypertrophic cardiomyopathy
• Congestive heart failure

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14-year old domestic long hair catMonty

• Hx Presented with dyspnea and lethargy.

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14-year old domestic long hair catMonty

• RF
• Greatly enlarged cardiac silhouette.
• Increased craniocaudal dimension
• Elevated trachea
• Increased sternal and diaphragmatic contact
• Increased width on the DV view
• Upward deviation of the caudal vena cava toward
  the heart
• Markedly enlarged pulmonary vessels.
• Mild loss of vascular margin clarity.
• RD
• Cardiomegaly and pulmonary congestion, mild
  pulmonary edema
• R/O
• Hypertrophic and dilatative cardiomyopathy
• Pericardial effusion
• Next Cardiac ultrasound

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2-year old MN Angora felineTrooper

• Hx Presented for evaluation of tachypnea and
  dyspnea.

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2-year old MN Angora felineTrooper

• RF
• Cardiac silhouette reveals a somewhat square
  appearance to the cranial cardiac margin.
• In the VD view the atrial region of the heart
  appears very wide, the ventricular region is
  obscured by superimposed opacity.
• Pulmonary vessels are at the upper limits of
  normal.
• Interstitial to alveolar lung pattern distributed
  in the perihilar region and ventral lung fields.
• In the VD views the pulmonary changes appear to
  be present in the caudal lung lobes.
• RD
• Hypertrophic cardiomyopathy
• Cardiogenic pulmonary edema
• R/O
• Left-sided congestive heart failure

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10-year old male miniature poodle

• Pre-treatment

• Post-treatment

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Pre-treatment
Post-treatment
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2-year old MN Angora felineTrooper

• RF
• Cardiac silhouette is too tall and too wide, with
  increased contact and elevation of the trachea.
• Left atrial enlargement, noted as loss of the
  caudal cardiac waist and increased soft tissue
  opacity.
• A heavy interstitial to alveolar pulmonary
  infiltrate is present, with the cranial lobes
  less affected. Thin pleural fissure lines are
  noted on the DV film, indicating subpleural fluid
  accumulation.
• The cranial lobar vessels on the lateral
  radiograph are prominent.
• RD
• Congestive heart failure with severe pulmonary
  edema
• Next Immediate therapy with a diuretic to lessen
  the pulmonary edema.

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6-year old Doberman Sarge

• Hx is easily stressed and has trouble breathing

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6-year old Doberman Sarge

• RF
• Elevated trachea.
• Heart at upper limits for craniocaudal width.
  Too wide.
• Increased cardiophrenic and cardiosternal
  contact.
• Partial loss of visualization of the pulmonary
  vessels (interstitial infiltrate).
• Accentuation of some of the bronchi/bronchioles
  due to interstitial infiltrate.
• Thin pleural fissure line over the heart, large
  caudal vena cava
• Lobar border noted between the right middle and
  caudal lung lobe.
• RD
• Cardiomegaly and cardiogenic pulmonary edema
• Next Echocardiogram

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16-year old dog Peter

• Hx Presented for lethargy. Has a severe systolic
  heart murmur.

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16-year old dog Peter

• RF
• Tracheal elevation
• Increased cardiophrenic and cardiosternal contact
• Loss of the caudal cardiac waist
• Increased soft tissue opacity between the
  mainstem bronchi on the DV film.
• Large caudal vena cava.
• Distended abdomen.
• Incidental is a mild sternal anomaly (S7-8).
• RD
• Marked generalized cardiomegaly
• Large CVC and impression of abdominal fluid
  suggest right heart failure
• R/O
• Right heart failure
• Severe RAV and LAV endocardiosis and
  insufficiency.
• Infectious vegetative valvular disease.

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7-year old MN Golden RetrieverBud

• Hx Presented for evaluation of lethargy,
  abdominal distension and increased respiratory
  rate.

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7-year old MN Golden RetrieverBud

• RF
• Increased opacity throughout the thoracic cavity
  obscures evaluation of the heart and diaphragm.
• In the VD view the lung lobes are separated from
  the internal surface of the thoracic wall by a
  band of soft tissue opacity.
• The lungs are retracted from the ventral thoracic
  cavity in the lateral view.
• There is an overall increase in opacity of the
  lung fields due to superimposition of the free
  pleural fluid.
• An air bronchogram is visible in the region of
  the right middle lung lobe.
• Increased size of the liver /- the presence of
  free abdominal fluid is suspected.
• RD
• Large volume of free pleural fluid
• R/O
• Cardiovascular disease
• Mediastinal mass
• Other neoplastic disease of the thoracic cavity
• Hepatic disease
• Next Echocardiogram, Thoracic ultrasound