Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지
DOI QR코드

DOI QR Code

Right-to-left Shunting Ventricular Septal Defect in a Dog

개에서 발생한 우-좌 단락 심실 중격 결손 증례

  • Yun, Sookyung (College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University) ;
  • Kim, Boeun (College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University) ;
  • Youn, Hwayoung (College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University) ;
  • Choi, Mincheol (College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University) ;
  • Yoon, Junghee (College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University)
  • Accepted : 2015.06.24
  • Published : 2015.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

A 4-year-old castrated male Dachshund was presented with a chronic history of dyspnea and cyanosis. Complete blood count revealed marked polycythemia with a hematocrit of 79.7%. Thoracic radiographs showed mild right-sided cardiac enlargement. Echocardiography showed a large ventricular septal defect in the left ventricular outflow tract region just proximal to the aortic valve. On Doppler echocardiography, right-to-left shunt flow through the defect was found and confirmed by contrast echocardiography. Based on these diagnostic findings and clinical signs, the dog was diagnosed as right-to-left shunting ventricular septal defect. Phlebotomy and oxygen supplement were performed, but the dog died the day after presentation.

4년령의 중성화된 수컷 Dachshund가 만성적인 호흡곤란 및 청색증을 주증으로 내원하였다. 혈액검사에서 헤마토크리트 79.7%의 심각한 적혈구증가증이 확인되었다. 흉부 방사선 영상에서는 경도의 우심 종대가 관찰되었다. 심초음파 검사에서 좌심실유출로 대동맥판막 근위부에서 큰 심실 중격 결손이 확인되었으며, 도플러 검사에서 이 결손을 통한 우-좌 션트가 확인되었으며 조영 심초음파를 통하여 최종적으로 확진되었다. 이러한 진단적 결과 및 환자의 임상증상을 바탕으로 환자는 우-좌 단락 심실 중격 결손증으로 진단되었다. 사혈 및 산소 공급을 실시하였으나 환자는 내원 다음날 집에서 사망하였다. 본 증례보고에서는 심초음파를 통한 우-좌 단락 심실 중격 결손증의 진단을 서술하였다.

Keywords

References

  1. Beghetti M, Tissot C. Pulmonary hypertension in congenital shunts. Rev Esp Cardiol 2010; 63: 1179-1193. https://doi.org/10.1016/S0300-8932(10)70250-5
  2. Coodwin JK, Hollan M. Contrast aortopraphy as an aid in the diagnosis of right-to-left shunting PDA. Vet Radiol 1995; 36: 157-159. https://doi.org/10.1111/j.1740-8261.1995.tb00238.x
  3. Daliento L1, Somerville J, Presbitero P, Menti L, Brach-Prever S, Rizzoli G, Stone S. Eisenmenger syndrome: Factors relating to deterioration and death. Eur Heart J 1998; 19: 1845-1855. https://doi.org/10.1053/euhj.1998.1046
  4. Edward C. feldman, Judith S. Nimmo-Wilkie, John W. Pharr. Eisenmenger's syndrome in the dog: case reports. J Am Anim Hosp Assoc 1981; 17: 477-483.
  5. Etienne Coete, Stephen J. Ettinger. Long-term clinical management of right-to-left ("reversed") patent ductus arteriosus in 3 Dogs. J Vet Intern Med 2001; 15: 39-42. https://doi.org/10.1111/j.1939-1676.2001.tb02295.x
  6. Ettinger S.J, Feldman E.C. Congenital heart disease. In: Textbook of veterinary internal medicine, 7th ed. St. Louis, Mo.: Elsevier Saunders, 2010: 1250-1298.
  7. Judith S, Edward C. Feldman. Pulmonary vascular lesions associated with congenital heart defects in three dogs. J Am Anim Hosp Assoc 1981; 17: 485-490.
  8. Julien I. E. Hoffman. Isolated ventricular septal defect. In: The natural and unnatural history of congenital heart disease. Hoboken, NJ: Wiley-Blackwell, 2009: 183-205ss.
  9. Langford Kidd, David J. Driscoll, Welton M. Gersony, Constance J. Hayes, John F. Keane, W. Michael O'fallon, Daniel R. Pieroni, Robert R. Wolfe, William H. Weidman. Second natural history study of congenital heart defects. Results of treatment of patients with ventricular septal defects. Circulation 1993; 87: I38-I51. https://doi.org/10.1161/01.CIR.87.1.38
  10. Mehmet Eren, Bahadir Dagdeviren, Osman Bolca, Mustafa Pola, Yekta Gurlertop, Tugrul Norgaz, Tuma Tezel. Proximal isovelocity surface area (PISA) as a noninvasive method for the estimation of the shunt quantification in perimembranous ventricular septal defects. Echocardiography 2001; 18: 137-147. https://doi.org/10.1046/j.1540-8175.2001.00137.x
  11. Moore KW, Stepien RL. Hydroxyurea for treatment of polycythemia secondary to right-to-left shunting patent ductus arteriosus in 4 dogs. J Vet Intern Med 2001; 15: 418-421. https://doi.org/10.1111/j.1939-1676.2001.tb02340.x
  12. Nakamura K, Yamasaki M, Ohta H, Sasaki N, Murakami M, Bandula Kumara WR, Takiguchi M. Effect of sildenafil citrate on five dogs with Eisenmenger's syndrome. J Small Anim Pract 2011; 52: 595-598. https://doi.org/10.1111/j.1748-5827.2011.01127.x
  13. Oliveira P, Domenech J, Silva J, Vannini S, Bussadori R, Bussadori C. Retrospective review of congenital heart disease in 976 dogs. J Vet Intern Med 2011; 25: 477-483. https://doi.org/10.1111/j.1939-1676.2011.0711.x
  14. Osama I.I. Soliman, Marcel L. Geleijinse, Flkert J. Meijboom, Attila Nemes, Otto Kamp, Petros Nihoyannopoulos, Navroz Masani, Steven B. Feinstein, Folkert J. Ten Cate. The use of contrast echocardiography for the detection of cardiac shunts. Eur J Echocardiogaphy 2007; 8: S2-S12. https://doi.org/10.1016/j.euje.2007.03.006
  15. Philp R. Fox, David Sisson, N. Sydney Moise. Congenital Heart Disease. In: Textbook of canine and feline cardiology, 2nd ed. Philadelphia: Saunders. 1999: 499-535.
  16. Rudolph AM. The changes in the circulation after birth: Their importance in congenital heart disease. Circulation 1970; 41: 343-359. https://doi.org/10.1161/01.CIR.41.2.343
  17. Simonneau G, Galie N, Rubin LJ, Langleben D, Seeger W, Domenighetti G, Gibbs S, Lebrec D, Speich R, Beghetti M, Rich S, Fishman A. Clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2004; 43: 5S-12S. https://doi.org/10.1016/j.jacc.2004.02.037
  18. Stevenson JG, Kawabori I, Dooley T, Guntheroth WG. Diagnosis of ventricular septal defect by pulsed Doppler echocardiography. Sensitivity, specificity and limitations. Circulation 1978; 58: 322-326. https://doi.org/10.1161/01.CIR.58.2.322
  19. Jason X. -J. Yuan, Joe G.N. Garcia, Charles A. Hales, Stuart Rich, Stephen L. Archer, John B. West. Textbook of pulmonary vascular disease, Boston: Springer, 2011: 1109-1168.