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一只患有肥厚型心肌病和充血性心力衰竭的猫,通过功能不全的卵圆孔出现了后天性左向右分流。

Acquired left-to-right shunting through a valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy and congestive heart failure.

作者信息

Winter Randolph L, Jennings Ryan N, Cronin James P, Rhinehart Jaylyn D, Schober Karsten E

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.

Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.

出版信息

JFMS Open Rep. 2020 Sep 28;6(2):2055116920959607. doi: 10.1177/2055116920959607. eCollection 2020 Jul-Dec.

Abstract

CASE SUMMARY

An 8-year-old spayed female domestic shorthair cat was presented for a recheck evaluation of hypertrophic cardiomyopathy and chronic kidney disease. Three years prior to presentation, the patient was diagnosed with obstructive hypertrophic cardiomyopathy and started on atenolol. The left ventricular outflow tract obstruction subsequently resolved. Biochemical analysis a week prior to presentation demonstrated severe azotemia. Transthoracic echocardiograph revealed pericardial effusion, pleural effusion, severe left ventricular concentric hypertrophy, severe left atrial enlargement and continuous left-to-right flow through the interatrial septum near the fossa ovalis. The patient was euthanized owing to poor prognosis, and gross examination at necropsy revealed a valve-incompetent patent foramen ovale secondary to severe left atrial dilation.

RELEVANCE AND NOVEL INFORMATION

To our knowledge, this is the first report of an acquired left-to-right shunt through a valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy. Severe left atrial dilation was suspected to cause interatrial shunting through the valve-incompetent foramen ovale, and this finding may be relevant to echocardiographic evaluations in other cats.

摘要

病例摘要

一只8岁已绝育的雌性家养短毛猫因肥厚型心肌病和慢性肾病复诊接受评估。就诊前三年,该患猫被诊断为梗阻性肥厚型心肌病并开始服用阿替洛尔。随后左心室流出道梗阻解除。就诊前一周的生化分析显示严重氮质血症。经胸超声心动图显示心包积液、胸腔积液、严重的左心室向心性肥厚、严重的左心房扩大以及卵圆窝附近房间隔处持续的左向右分流。由于预后不良,该患猫实施了安乐死,尸检大体检查发现继发于严重左心房扩张的卵圆孔未闭且瓣膜功能不全。

相关性及新信息

据我们所知,这是首例关于肥厚型心肌病猫通过瓣膜功能不全的卵圆孔出现获得性左向右分流的报道。怀疑严重的左心房扩张导致通过瓣膜功能不全的卵圆孔出现房内分流,这一发现可能与其他猫的超声心动图评估有关。

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