Physiologic Murmur in Dogs

Physiologic Murmur in Dogs

A physiologic murmur is common in large-breed dogs.  

This represents mild turbulence within the great vessels and is not the result of structural heart disease.  

No treatments or medications are required.

Pulmonary Arterial Hypertension in Dogs

Pulmonary Arterial Hypertension in Dogs

Pulmonary arterial hypertension is a state of high blood pressure within the lung (pulmonary) circulation.  

This condition can be due to heartworm disease and embolic disease (clots into the lungs); however, some cases are considered idiopathic (cause unknown).  

Many cases may also develop pulmonary arterial hypertension due to chronic airway disease (pulmonary fibrosis, cancer, or pneumonia).  

This disease process involves damage to the pulmonary arteries and thickening/constriction of these vessels, increasing resistance to flow.  

Medications are utilized to reduce the pulmonary arterial pressures and improve quality of life.  

No medications can return these pressures to normal; however, many patients display a significant improvement in their quality of life.

Systemic Hypertension in Dogs

Systemic Hypertension in Dogs

Systemic Hypertension is a state of high blood pressure within the body.

This means that the heart must work very hard to propel blood forward, which increases oxygen demands and can cause changes to the myocytes (muscle cells).  

In veterinary medicine, this condition is typically a result of chronic kidney disease, thyroid disease, or various other metabolic conditions.  In some cases, essential (idiopathic) hypertension may be suspected.  

This condition can cause severe end-organ damage to include the brain, heart, kidneys, and eyes.  

If an underlying condition can be identified, treatment is directed towards that condition and maintaining the systemic blood pressure at a reasonable level with medications.  

Frequent rechecks are required to optimize the dose of anti-hypertensive medications.

Heart Base Tumors in Dogs

Heart Base Tumors in Dogs

Heart Base Tumors are most frequently chemodectomas, which are benign, slow growing tumors of the aortic body chemoreceptors.  

These tumors can cause the accumulation of fluid within the pericardial sac (pericardial effusion), which can eventually be enough to cause cardiac tamponade (collapse of the chambers of the heart).  

This condition is typically best managed by surgical removal of the pericardium (pericardial window or subtotal pericardectomy) as the rate of fluid accumulation is typically very slow.  

These tumors are poorly responsive to chemotherapy and radiation given their very slow growth patterns.  

Recheck echocardiograms are warranted to monitor for any changes that may suggest a different tumor type, such as a carcinoma.

Right Auricular Mass in Dogs

Right Auricular Mass in Dogs

A right atrial/auricular mass is most likely a hemangiosarcoma.  

Other tumor types would include chemodectoma or carcinoma.  

The prognosis is typically poor; however, with chemotherapy and surgery (pericardectomy or pericardial window), these patients can typically have a high quality of life.

Their overall life expectancy is unfortunately short (typically 90-120 days).  Consultation with an oncologist is highly recommended to discuss potential treatment strategies and the associated survival times and quality of life with each potential chemotherapeutic option

Pericardial Effusion in Dogs

Pericardial Effusion in Dogs

Pericardial Effusion is a condition where there is a fluid accumulation within the pericardial sac.  

This causes the pressures outside of the heart to rise.  

When a critical pressure is reached, the chambers of the heart begin to collapse, a condition called tamponade.  

This is a life-threatening emergency and requires immediate medical attention as death will occur shortly after the development of tamponade.  

The fluid is often due to a tumor located in the heart base or right auricular region.

Recheck echocardiograms are necessary as some masses that bleed are very small and cannot be identified during the initial examination.

Surgical procedures such as a pericardial window or subtotal pericardectomy (removal of the sac) can prevent tamponade from returning; however, there is a risk of uncontrolled hemorrhage with these procedures.

A pericardiocentesis is a procedure where a needle is inserted into the pericardial sac and the fluid is removed.  This fluid is submitted for cytologic review

Dilated Cardiomyopathy in Dogs

Dilated Cardiomyopathy in Dogs

Dilated Cardiomyopathy is a primary myocardial disease wherein the heart muscle is damaged and becomes very weak.  

The left ventricle dilates and has a marked systolic dysfunction (pump dysfunction).  

This causes an elevation in left ventricular and left atrial pressures as the poorly pumping chamber continues to dilate.  

Eventually, this results in dilation of the left atrium and fluid accumulation within the lungs (congestive heart failure).  

This makes breathing difficult and requires urgent medical attention.

Unfortunately, there is no cure for this disease.  

Ongoing rechecks and medical management are utilized to maximize the quality of life for affected patients.  

The disease progression is variable, with some patients doing well for years and others progressing into congestive heart failure rapidly.  

This disease is also frequently associated with the development of arrhythmias (abnormal electrical beats) that can predispose affected patients to sudden death.

Additional diagnostics, such as 24 hour Holter Monitors, may be recommended based on our initial findings.  

If any clinical signs of arrhythmias such as a “dazed” appearance or collapse are noted, please contact your trusted veterinarian or your local emergency clinic immediately.

Chronic Valve Disease in Dogs

Chronic Valve Disease in Dogs

Myxomatous Mitral Valve Degeneration (i.e. Chronic Valve Disease or Endocardiosis) is a chronic, degenerative disease of the mitral valve (62% of affected patients have only mitral valve changes).

The normally thin and delicate valve leaflets are damaged and the tissue replaced with a thickened, non-pliable tissue.  

This causes the valve leaflets to become thickened, irregular, and have poor coaptation (closure).  

This poor coaptation allows reverse blood flow (left ventricle into left atrium), which is termed regurgitation or insufficiency.  

This disease is progressive and unfortunately, there is no cure.  

Routine rechecks are required to monitor for any changes to the left atrium or ventricle that may warrant additional testing or direct medical management of this disease.  

Eventually, this disease can lead to the development of congestive heart failure (fluid in the lungs), which is a medical emergency that makes breathing very difficult.  

This disease can also affect the tricuspid valve (right side of the heart) and cause similar problems.  

One study indicates 32.5% of cases have concurrent mitral and tricuspid valve degeneration.  This study indicated 1.3% of affected patients have only tricuspid valve changes.