Thomason Justin D, Radlinsky MaryAnn G, Rapoport Gregg, Howerth Elizabeth W, Acevedo Karelma Frontera, Fallaw Tiffany L, Calvert Clay A
Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
J Feline Med Surg. 2012 Apr;14(4):276-9. doi: 10.1177/1098612X11435041. Epub 2012 Jan 10.
A 4-year-old Ragdoll cat presented for dyspnea secondary to chylous pleural effusion to the University of Georgia Veterinary Teaching Hospital. Physical examination, complete blood count, serum chemistries, urinalysis, thoracic radiographs, abdominal radiographs, and thoracic fluid cytology and culture failed to identify an etiology for the chylous effusion. The patient tested negative for feline leukemia virus, feline immunodeficiency virus and heartworm disease. Respiration phasic influences on early diastolic trans-mitral, trans-tricuspid and pulmonary vein blood flow velocities during Doppler echocardiography were consistent with constrictive pericarditis. The cat underwent subtotal pericardectomy. The patient recovered without complication and is overtly healthy without radiographic or echocardiographic abnormalities 6-months post-surgery. Constrictive pericarditis should be considered in cats with idiopathic pleural effusion, with or without ascites, in which standard echocardiographic assessment is not suggestive of structural heart disease. If constrictive pericarditis is present, the Doppler characteristics outlined here may allow for this diagnosis to be made. Pericardectomy may be highly rewarding, although the specific etiology of the constrictive pericarditis may remain unknown.
一只4岁的布偶猫因乳糜性胸腔积液继发呼吸困难被送至佐治亚大学兽医教学医院。体格检查、全血细胞计数、血清生化检查、尿液分析、胸部X光片、腹部X光片以及胸液细胞学检查和培养均未能确定乳糜性积液的病因。该患者猫白血病病毒、猫免疫缺陷病毒和心丝虫病检测均为阴性。在多普勒超声心动图检查期间,呼吸相位对早期舒张期二尖瓣、三尖瓣和肺静脉血流速度的影响与缩窄性心包炎一致。这只猫接受了心包次全切除术。患者术后恢复良好,无并发症,术后6个月无影像学或超声心动图异常,外表健康。对于患有特发性胸腔积液(无论有无腹水)且标准超声心动图评估未提示结构性心脏病的猫,应考虑缩窄性心包炎。如果存在缩窄性心包炎,此处概述的多普勒特征可能有助于做出此诊断。心包切除术可能会有很好的效果,尽管缩窄性心包炎的具体病因可能仍然不明。