Radiology Packet 4

Cardiac Enlargement
 9 year old shetland sheepdog
“Alt”
• Hx: Presented for coughing, exercise intolerance and has a systolic murmur
 9 year old shetland sheepdog
“Alt”
• RF
– Lateral
• Elevation of the trachea.
• Heart is taller than it should be.
• Marked loss of the caudal cardiac waist with soft tissue structure
overlying the caudal heart base region.
• Upward deviation toward the heart of the caudal vena cava.
• Increased cardiophrenic contact.
• Prominent pulmonary vessels.
– DV
• Large soft tissue opacity of the hilar region, between the mainstem
bronchi, which can be followed over to the 3 o’clock position (left
atrium and auricle).
• R/O
– Mitral insufficiency and secondary heart enlargement

• Next: Cardiac ultrasound

 10 year old M German Shepherd
“Civa”
• Hx: Dog is bradycardic and premature ventricular contractions were
noted on ECG
 10 year old M German
Shepherd “Civa”
• RF
– Mild generalized cardiac enlargement.
– Incidental finding of spondylosis at several sites in the
thoracic spine.
• R/O
– Dilatative cardiomyopathy
– Pericardial effusion
• Next: ECG
 10 year old cocker spaniel MN
“Sprocket”
• Hx: Presented for evaluation of a chronic cough. No signs of systemic
illness and no heart murmur is ausculted. The patient has been treated with
Furosemide (Lasix), Enalapril (cardiac drug) and Hycodan (cough
suppressent)
.
 10 year old cocker spaniel MN
“Sprocket”
• RF
– Right ventricular enlargement.
– Trachea is mildly elevated so right atrial enlargement may also be
present.
– Diffuse mild interstitial lung pattern consistent with normal age change.
– Liver is mildly enlarged.
• R/O
– Right sided cardiac enlargement
• Cor pulmonale
• Aquired right-sided cardiac enlargement (relatively uncommon)
– Bronchitis
 6 year old FS Bernese Mountain
Dog
• Hx: Presented for surgical repair of a cranial cruciate ligament rupture. While under
general anesthesia occasional ventricular pre-mature contractions were noted.
 6 year old FS Bernese Mountain
Dog
• RF
- Microcardia and small size of the pulmonary vessels.
- Lung fields are over-exposed making evaluation more difficult
• RD
– hypovolemia
• R/O
– Dehydration
– Shock
– Addison’s disease (hypoadrenocorticism)

• Next: ACTH stimulation test

 4 year old German Shorthair
Pointer “Autumn”
• Hx: Has had 2 episodes of mild weakness/collapse associated with
intense exercise. A persistent cough is also reported. A systolic
murmur with the point of maximal intensity at the aortic valve was
noted ~1 year ago.
 4 year old German Shorthair
Pointer “Autumn”
• RD
– Mild right-sided cardiac enlargement
– Moderate diffuse interstitial lung pattern with bronchial markings (not prominent
enough to call a broncho-interstitial lung pattern)

• R/O
– Tricuspid valve insufficiency
– Cor pulmonale (increased size of the right heart due to pulmonary hypertension)
– Presence of interstitial pattern is non-specific and R/O include lungworm
infestation, interstitial pneumonia and interstitial changes due to prior pulmonary
disease

• Next:
– Echocardiography
– Baermann fecal exam
 12 year old DSH “Tuffy”
• Hx: Presented for mild ataxia. The owners report the cat seems to
be breathing rapidly. Auscultation of the thorax was unrewarding.
 12 year old DSH “Tuffy”
• RF
– Increased sternal contact of the heart and the aorta has a prominent
appearance.
– Cardiac silhouette is wider than normal.
– Cranial border is slightly square on the lateral view.
– Heart has a “Valentine” shape.
– The cranial pulmonary vessels are seen and at the upper limits of
normal size.

• RD
– Hypertrophic cardiomyopathy

• Next
– Echocardiogram
 6-year old MN DSH
“Fatty Lumpkin”
• Hx: Presented for evaluation of lethargy and increased respiratory rate
 6-year old MN DSH
“Fatty 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.
– Mild pulmonary vascular congestion is present as well as free pleural
fluid.

• RD
– Hypertrophic cardiomyopathy
– Congestive heart failure
 9-year old MN Schipperke
“Robbie”
• Hx: Presented for evaluation of a cardiac murmur. The murmur was
not present the previous year. It is described as a grade 2-3 of 6
systolic murmur.
 9-year old MN Schipperke
“Robbie”
• RF
– Caudal mainstem bronchi are elevated and there is loss of the caudal
cardiac waste.
– In VD the left atrium is visible as a large round structure caudal to the
mainstem bronchi bifurcation.
– The entire trachea is elevated and the caudal cardiac margin is
elongated.
– In the VD there is mild bulging in the left ventricular region.

• RD
– Left atrial and ventricular enlargement

• R/O
– Mitral regurgitation secondary to mitral valve endocardiosis
 12 year old M Saluki
“Linca”
• Hx: Presented with a 1 week history of lethargy and poor appetite. On PE
the abdomen appears distended and a fluid wave can be balloted. On
auscultation the heart sounds are muffled and of variable intensity.
 12 year old M Saluki
“Linca”
• RF
– Cardiac silhouette is enlarged and very round.
– In the lateral view a single pleural fissure line is visible.

• RD
– Globoid cardiac silhouette
– Pericardial effusion

• R/O
– Hemangiosarcoma of the right atrium
– Heart base mass (lymphosarcoma) within the pericardial sac
– Idiopathic pericardial effusion
– Pericardial effusion leading to right sided heart failure
– Underlying cardiac disease such as dilated cardiomyopathy and tricuspid
dysplasia
– Peritoneopericardial diaphragmatic hernia