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Heart
- Author: Romain Pariaut
- From: BSAVA Manual of Canine and Feline Ultrasonography
- Item: Chapter 6, pp 37 - 71
- DOI: 10.22233/9781910443118.6
- Copyright: © 2011 British Small Animal Veterinary Association
- Publication Date: January 2011
Abstract
Transthoracic cardiac ultrasonography, or echo-cardiography, provides high-quality images of the heart, great vessels and paracardiac structures. It has developed into an essential diagnostic tool for the evaluation of dogs and cats with cardiac disease. This chapter looks at indications and the value of echocardiography compared with radiography. It moves on to address imaging technique and normal echocardiographic appearance. Congenital cardiac diseases, acquired valvular diseases, myocardial diseases, pericardial diseases and screening programmes for cardiac diseases are all covered. This chapter contains 30 video clips.
Heart, Page 1 of 1
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Left cranial view of the right atrium.
The right ventricle is seen closest to the transducer in this clip, with the right atrium deep to it. Movement of the right atrioventricular valve leaflets is clearly seen. Both the caudal and the cranial venae cavae can be seen entering the right atrium.
Patent ductus arteriosus viewed from the left cranial window.
This clip, using colour flow Doppler, demonstrates turbulent blood flow (with a mosaic of colours) shunting from the aorta into the pulmonary artery through the PDA.
Patent ductus arteriosus viewed from a transoesophageal approach.
The probe is placed over the oesophagus, cranial to the heart base, allowing a detailed view of the PDA (at the top of the screen). Colour flow Doppler is used to demonstrate the turbulent blood flow shunting from the PDA into the main pulmonary artery.
Patent ductus arteriosus.
This clip shows a right parasternal long-axis four-chamber view in a dog with a PDA. Although the PDA itself is not visible, there is left ventricular dilatation. Contractility remains within normal limits.
Bubble study.
Right parasternal long-axis four-chamber view in a dog during injection of agitated saline. Microbubbles are visible in the right cardiac chambers. In this normal dog, no contrast medium is seen within the left cardiac chambers.
Atrial septal defect.
The right atrium and ventricle are at the top of the screen, with the left atrium and ventricle below. The left atrium is markedly dilated secondary to mitral valve regurgitation. Left-to-right flow of blood across an ostium secundum ASD is demonstrated by colour flow Doppler.
Ventricular septal defect (1).
This clip shows a right parasternal short-axis view of the heart of a cat. The aorta is the round structure in the centre of the heart, with the right ventricle wrapped around it at the top of the screen. A small VSD (10 o’clock position) at the level of the left ventricular outflow tract is present. Turbulent blood flow can be seen to cross the defect into the right ventricle. The position of the defect and the turbulence of the flow indicate that the defect is perimembranous and restrictive.
Ventricular septal defect (2).
A right parasternal long-axis outflow view of the same cat as in Ventricular septal defect (1). A turbulent jet of blood is seen crossing from the left ventricle into the right ventricle just below the aortic valve.
Subaortic stenosis (1).
These clips show a right parasternal short-axis view of the heart in a dog. The right-hand clip shows a mosaic of colours within the central aorta, indicating turbulent blood flow. This turbulence was secondary to an SAS.
Subaortic stenosis (2).
This apical view shows the left ventricle in the center of the image close to the transducer, with the left atrium deep to it. Colour Flow Doppler shows turbulent flow in the left ventricular outflow tract during systole due to subaortic stenosis. There is mild aortic insufficiency during diastole.
Subaortic stenosis (3).
A right parasternal long-axis four-chamber view of the heart in a dog with SAS, showing concentric hypertrophy of the left ventricle. This dog also had moderate pulmonic stenosis, causing right ventricular wall hypertrophy.
Subaortic stenosis (4).
A right parasternal short-axis view of the left ventricle in a dog with SAS, showing diffuse concentric hypertrophy. Note the hyperechoic areas on the papillary muscles, which may indicate ischaemic lesions.
Pulmonic stenosis (1).
These clips show a right parasternal short-axis view of the heart at the level of the pulmonary artery. The dog was diagnosed with valvular pulmonic stenosis and subvalvular stenosis. On the 2D clip, the valve is clearly visible (towards the right of the screen), as is the hyperechoic membrane above the valve. Note the post-stenotic dilatation that accompanies the valvular stenosis. When colour Doppler is added to the 2D image, turbulent blood flow is seen originating from the hyperechoic membrane, which is consistent with subvalvular stenosis.
Pulmonic stenosis (2).
A right parasternal short-axis view, centred on the pulmonic valve. Note the motion of this doming valve. There is post-stenotic dilatation of the pulmonary artery.
Tricuspid valve dysplasia (1).
This clip shows a right parasternal short-axis view at the level of the ventricle in a dog with tricuspid valve dysplasia. The right ventricle is severely dilated. Flattening of a portion of the septum is visualized in diastole.
Tricuspid valve dysplasia (2).
A right parasternal long-axis four-chamber view of the heart of the same dog as in Tricuspid valve dysplasia (1), showing marked dilatation of the right atrium, which lies superficially and to the right of the screen. A puff of turbulent blood seen entering the right atrium across the tricuspid valve leaflets indicates tricuspid valve regurgitation.
Tricuspid valve prolapse.
This clip shows prolapse of the septal leaflet of the tricuspid valve into the right atrium.
Tricuspid valve regurgitation.
The left ventricle lies to the left of the screen, with the left atrium deep to it. The left atrium is dilated secondary to severe mitral valve endocardiosis. The right cardiac chambers lie to the right of the screen, and moderate tricuspid valve regurgitation is demonstrated with colour flow Doppler.
Mitral valve regurgitation (1).
Right parasternal long-axis four-chamber view in a dog with severe mitral valve endocardiosis. The left atrium and left ventricle are severely dilated. The mitral valve leaflets are thickened and the septal leaflet is seen to prolapse into the left atrium.
Mitral valve regurgitation (2).
Colour flow Doppler examination in the same dog as in Mitral valve regurgitation (1), demonstrating moderate mitral valve regurgitation and an eccentric jet.
Mitral valve regurgitation (3).
In this clip, a severe jet of mitral valve regurgitation is seen due to mitral valve insufficiency associated with endocardiosis.
Endocarditis (1).
This clip shows a right parasternal short-axis view at the level of the aortic valve in a dog with endocarditis. Irregular, hyperechoic, vegetative lesions are present on all three aortic cusps.
Endocarditis (2).
A right parasternal long-axis outflow view in the same dog as in Endocarditis (1). Note the large hyperechoic vegetations on the ventricular side of the aortic cusps.
Hypertrophic cardiomyopathy (1).
This clip shows a right parasternal short-axis view at the level of the papillary muscles in a cat. Systolic cavity obliteration due to severe hypertrophy of the left ventricle can be seen.
Hypertrophic cardiomyopathy (2).
A right parasternal long-axis four-chamber view of the heart in a cat with HCM, showing marked enlargement of the left atrium. The left ventricular free wall is diffusely thickened, and there is thickening of the base of the interventricular septum. Note the presence of a small pericardial effusion.
Systolic anterior motion of the chordae.
This clip, recorded from a right parasternal approach, demonstrates SAM of a chordae tendinae attached to the septal leaflet of the mitral valve.
Systolic anterior motion of the mitral valve.
These clips were recorded from a right parasternal window in a cat with SAM of the mitral valve. Turbulent blood flow is present in the left ventricular outflow tract during systole, accompanied by mild mitral valve regurgitation.
Pericardial effusion.
This clip shows a right parasternal short-axis view at the level of the papillary muscles. The heart is seen moving within a large amount of pericardial fluid.
Right atrial mass.
A left apical four-chamber view in a dog, showing a large hypoechoic right atrial mass. The mass expands into the right ventricular chamber and around the tricuspid valve.
Heart base mass.
This clip shows a large heart base mass in a dog, which expands into both the right and left atria.