Echocardiographic Diagnosis of Intracardiac Masses in Yorkshire Terrier Dogs : 2 Cases

요크셔테리어 개에서 심장초음파를 이용하여 진단된 심장내 종괴 2 증례

  • Han, Donghyun (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Kim, Hyunji (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Hyun, Changbaig (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University)
  • 한동현 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 김현지 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)
  • Accepted : 2012.12.14
  • Published : 2012.12.31

Abstract

Primary and metastatic tumors involving the heart are relatively uncommon in dogs. In this study, we provide the echocardiographic diagnosis of intracardiac masses in 2 Yorksire terrier dogs. In the first case, the mass was attached between ascending aorta and pulmonary artery and caused moderate aortic regurgitation and moderate left ventricular dilation. The case was graded into ISACHC II heart failure. The dog was treated with common cardiac medications (i.e. furosemide, enalapril, pimobendan) and oral chemotherapeutic agent (i.e. lomustine). In the second case, the mass was occupied 2/3 of the left atrium and caused marked dilation of left atrium and severe mitral regurgitation (~5 m/s), but not severe congestive heart failure (ISACHC Ib). Although the nature of progression of the mass was likely to cardiac myxoma, the biopsy was not performed due to the owner's refusal. The dog was currently treated with cardiac medications (i.e. ramipril, clopidogrel) and bronchodilator (i.e. aminophylline). Those two dogs are still survived and are currently regularly checked.

심장에 발생하는 원발성 그리고 전이성 종양은 개에서는 흔치 않다. 우리는 본 연구에서 심장초음파적 진단을 이용하여 요크셔테리어 2마리에서 발생한 심장내 종괴를 확인하였다. 첫째 증례에서의 종괴는 상행 대동맥과 폐동맥 사이에 위치하고 있었으며, 중증도의 대동맥 역류와 좌심실의 확장을 유발하고 있었다. 이 증례의 환자등급은 ISACHC II 등급의 심부전으로 분류되었다. 환자에 대한 심장처방으로는 furosemide, enalapril, pimobendan 그리고 경구적인 화학요법으로는 lomustine가 처방되었다. 둘째 증례에서의 종괴는 좌심방의 2/3를 차지하고 있었으며, 좌심방의 확연한 확장과 심각한 이첨판 역류 (~5 m/s) 를 유발하고 있었으나, 환자의 심부전 등급은 ISACHC Ib 등급으로 심각한 울혈성 심부전은 나타나지 않았다. 종괴의 성상은 cardiac myxoma로 추정되었으나, 조직생검검사는 보호자의 거절로 인하여 수행되지 않았다. 환자에 대한 심장처방으로는 ramipril, clopidogrel 그리고 기관지 확장제는 aminophylline이 처방되었다. 본 증례의 두 환자들은 여전히 생존해 있으며, 정기적인 검진을 받고 있다.

Keywords

References

  1. Colucci WS, Braunwald E. Primary tumors of the heart. In: Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine, 4th ed. Philadelphia, PA: WB Saunders; 1992:1451-1464.
  2. Darke PGG, Gordon LR. Cardiac myxoma in a dog. Vet Rec 1974; 95: 565-567. https://doi.org/10.1136/vr.95.25-26.565
  3. Hayes HM. A hypothesis for the aetiology of canine chemoreceptor system neoplasms, based upon an epidemiological study of 73 cases among hospital patients. J Small Anim Pract 1975; 16: 337-343. https://doi.org/10.1111/j.1748-5827.1975.tb05751.x
  4. Kleine LJ, Zook BC, Munson TO. Primary cardiac hemangiosarcoma in dogs. J Am Vet Med Assoc 1970; 157: 326-337.
  5. Kustos G, Bohenszky G, Torok B. Multiple myxoma of the heart valves in dogs. Magy Allatorv Lapja 1964; 19: 205-206.
  6. Reynen K. Cardiac myxomas. N Engl J Med 1995; 333:1610-1617. https://doi.org/10.1056/NEJM199512143332407
  7. Luginbuhl H, Detweiler DK. Cardiovascular lesions in dogs. Ann NY Acad Sci 1968; 127: 517-540.
  8. Thomas WP, Sisson D, Bauer TG. Detection of cardiac masses in dogs by two-dimensional echocardiography. Vet Radiol 1984; 25: 65-72. https://doi.org/10.1111/j.1740-8261.1984.tb01911.x
  9. Ware WA, Hopper DL. Cardiac tumors in dogs: 1982-1995. J Vet Intern Med, 1999; 13: 95-103.
  10. Zook BC. Some spontaneous cardiovascular lesions in dogs and cats. Adv Cardiol 1974; 13: 148-168.