Radiology Packet 7

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Radiology Packet 7

• Congenital cardiac disease

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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.

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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

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16-month old Jack Russell TerrierBandit

• Hx Presented for exercise intolerance and
  polycythemia (PCV 60-75)

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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 oclock
  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

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10-month old Domestic Long HairKristen

• Hx Presented for routine overiohysterectomy.
  During PE a grade 6 of 6 systolic murmur was
  ausculted.

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10-month old Domestic Long HairKristen

• 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 VSDs on rads)

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3.5-month old Brittany SpanielNel

• Hx Clinically normal but is noted to have a
  continuous heart murmur that is grade 5 of 6.

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3.5-month old Brittany SpanielNel

• 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

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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.

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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
  oclock position.
• RD
• Aortic stenosis
• Next
• Cardiac ultrasound

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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.

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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

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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.

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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 oclock 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

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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.

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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

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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

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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