Möhr A J, Kirberger R M
Department of Companion Animal Medicine, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
J S Afr Vet Assoc. 2000 Jun;71(2):125-30. doi: 10.4102/jsava.v71i2.695.
An 8-month-old Labrador retriever bitch was evaluated for sudden-onset, progressive abdominal distension. Physical examination revealed an exaggerated inspiratory effort, severe ascites, bilateral jugular vein distension, and hypokinetic femoral arterial pulses. Thoracic auscultation detected tachycardia with muffled heart sounds, without audible cardiac murmurs. Thoracic radiographs identified severe right ventricular enlargement and pleural effusion. The electrocardiogram was consistent with incomplete right bundle branch block or right ventricular enlargement. Echocardiography demonstrated severe right ventricular and atrial dilation, secondary tricuspid regurgitation, and thinning and hypocontractility of the right ventricular myocardium. Left heart chamber sizes were slightly decreased, with normal left ventricular contractility. A diagnosis of arrhythmogenic right ventricular cardiomyopathy was reached, based on the characteristic clinical, electrocardiographic, radiographic and echocardiographic findings, and the exclusion of other causes of isolated right ventricular failure. Treatment effected good control of clinical signs, until acutely decompensated congestive right heart failure led to euthanasia after 4 months. Arrhythmogenic right ventricular cardiomyopathy is a well-described clinical entity in humans, and has previously been documented in 3 male dogs. The condition is characterised by progressive fibro-adipose replacement of right ventricular myocardium, while the left ventricle usually remains unaffected. It should be considered a differential diagnosis in any young dog presented with isolated right heart failure, syncope, or unexplained ventricular tachyarrhythmias. This article reports the 1st case of arrhythmogenic right ventricular cardiomyopathy in a female dog, and highlights its echocardiographic features.
一只8个月大的拉布拉多母犬因突发进行性腹胀接受评估。体格检查发现吸气动作夸张、严重腹水、双侧颈静脉扩张以及股动脉搏动减弱。胸部听诊发现心动过速且心音低沉，未闻及心脏杂音。胸部X光片显示严重的右心室扩大和胸腔积液。心电图表现与不完全性右束支传导阻滞或右心室扩大一致。超声心动图显示严重的右心室和心房扩张、继发性三尖瓣反流以及右心室心肌变薄和收缩力减弱。左心腔大小略有减小，左心室收缩功能正常。根据特征性的临床、心电图、X光和超声心动图表现，并排除其他导致单纯性右心室衰竭的原因，诊断为致心律失常性右心室心肌病。治疗有效控制了临床症状，但4个月后急性失代偿性充血性右心衰竭导致实施安乐死。致心律失常性右心室心肌病在人类中是一种已被充分描述的临床病症，此前在3只雄性犬中也有记录。该病的特征是右心室心肌逐渐被纤维脂肪组织替代，而左心室通常不受影响。对于任何出现单纯性右心衰竭、晕厥或不明原因室性快速心律失常的幼犬，都应考虑将其作为鉴别诊断。本文报告了首例雌性犬致心律失常性右心室心肌病病例，并突出了其超声心动图特征。
