case number 22
A 6 month old male Viszla was presented due to 1 episode of syncopy, and hind limbs weakness.
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interpretation:
There is a severe and diffuse bronchointerstitial pattern, rounding of the caudal lung lobes with scant fissure lines, suggesting pleuritis or fibrosis.
There is a main pulmonary artery dilatation (bulge between 1 o'clock and 2 o'clock on the vd view, and loss of cranial waist on the lateral view) with moderate right ventricular enlargement. The right cranial pulmonary artery is slightly tortuous.
Differential diagnoses:
Diffuse broncointestitial pattern: bronchitis or bronchopneumonia (allergic, infectious, secondary to cardiac disease, inhaled irritants or pulmonary migratory parasites).
Main pulmonary dilatation with right chamber enlargement:
Pulmonic stenosis
Heart worm disease (in andemic areas)
Pulmonary hypertension- primary (rare in dogs), secondary as a sequella of a cardiac or pulmonary disease
Diagnosis: pulmonary hypertension (confirmed by an echocardiogram, Doppler studies , spectral Doppler studies and micro bubble studies to rule out congenital defects)
The key in this case is to recognize the pulmonary pattern that accompanies the cardiac findings.