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New page: {{toplink |backcolour = |linkpage =Cardiology - WikiClinical |linktext =Cardiology |sublink1=Cardiovascular Conditions - WikiClinical |subtext1=CARDIOVASCULAR CONDITIONS |maplink1= Cardiov...
{{toplink
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
*Common in dogs
*Rare in cats
*Very rare in horses as an isolated abnormality; usually part of Tetralogy of Fallot
===Signalment===
Genetics & Predisposed Breeds: Most common in smaller breeds (Miniature Schnauzer, Fox Terrier, Chihuahua, Miniature Pinscher); Larger breeds are also affected (Labrador Retriever, Newfoundland, Mastiff, Samoyeds); Terrier Breeds are frequently affected
===Description===
The three possible areas for pulmonic stenosis to occur:
1. Subvalvular or subpulmonic (occurs below the valve)
2. Valvular (occurs at the valve)
3. Supravalvular (occurs above the valve)
*Stenosis of the pulmonary outflow tract is the result of dysplastic changes in the pulmonic valve
*Most cases of pulmonic stenosis are valvular
*Supravalvular pulmonic stenosis is rare
*Concentric hypertrophy of the right ventricle forms as a direct result of the chronic pressure overload needed to surpass the increased resistance from the stenotic pulmonary outflow tract
*Concentric hypertrophy causes decreased ventricular filling during diastole
*Elevated right atrial pressure from the blood unable to fill the ventricle causes atrial dilation
*Tricuspid valve regurgitation can also be present and adds to the atrial pressure
*In addition to the diagnostic methods listed below, angiography may be used to show the defect
===Diagnosis===
====History & Clinical Signs====
-Exercise Intolerance
-Syncope
-Signs of right sided congestive heart failure (severely affected)
-Asymptomatic (mildly affected)
====Physical Exam====
-Systolic ejection murmur over pulmonary artery in the left heart base
-Usually normal femoral pulses
-Signs of right sided congestive heart failure may be present:
*ascites
*jugular distension & jugular pulses
====Radiographic Findings====
-Right ventricular enlargement (DV view seen at 1 o'clock)
-Right atrial enlargement
-Pulmonary artery enlargement (DV view seen at 2 o'clock)
(Changes are seen the most clearly on a dorsoventral view)
====Echocardiographic Findings====
-Right ventricular hypertrophy
-Poststenotic dilation of the pulmonary artery
-Abnormal pulmonic valve if the stenotic area is valvular
Doppler can be used to measure the pressure in the stenotic area and visualize abnormal flow
====Electrocardiographic (ECG)====
-Right ventricular hypertrophy (deep S waves, right axis deviation)
===Treatment===
Mild/Moderate Cases
-If there are no signs, no treatment is needed
Severe Cases
-Animals that exhibit many of the clinical signs will need further treatment
*Balloon valvuloplasty (done if pulmonic leaflets are fused)
*Surgical repair (done when more complex lesions & obstructions are present): valvulotomy, pericardial patch graft
===Prognosis===
Mild/Moderate Cases
-Good prognosis
Severe Cases
-Guarded prognosis
|backcolour =
|linkpage =Cardiology - WikiClinical
|linktext =Cardiology
|sublink1=Cardiovascular Conditions - WikiClinical
|subtext1=CARDIOVASCULAR CONDITIONS
|maplink1= Cardiovascular Conditions (Content Map) - WikiClinical
|pagetype=Clinical
}}
<br>
*Common in dogs
*Rare in cats
*Very rare in horses as an isolated abnormality; usually part of Tetralogy of Fallot
===Signalment===
Genetics & Predisposed Breeds: Most common in smaller breeds (Miniature Schnauzer, Fox Terrier, Chihuahua, Miniature Pinscher); Larger breeds are also affected (Labrador Retriever, Newfoundland, Mastiff, Samoyeds); Terrier Breeds are frequently affected
===Description===
The three possible areas for pulmonic stenosis to occur:
1. Subvalvular or subpulmonic (occurs below the valve)
2. Valvular (occurs at the valve)
3. Supravalvular (occurs above the valve)
*Stenosis of the pulmonary outflow tract is the result of dysplastic changes in the pulmonic valve
*Most cases of pulmonic stenosis are valvular
*Supravalvular pulmonic stenosis is rare
*Concentric hypertrophy of the right ventricle forms as a direct result of the chronic pressure overload needed to surpass the increased resistance from the stenotic pulmonary outflow tract
*Concentric hypertrophy causes decreased ventricular filling during diastole
*Elevated right atrial pressure from the blood unable to fill the ventricle causes atrial dilation
*Tricuspid valve regurgitation can also be present and adds to the atrial pressure
*In addition to the diagnostic methods listed below, angiography may be used to show the defect
===Diagnosis===
====History & Clinical Signs====
-Exercise Intolerance
-Syncope
-Signs of right sided congestive heart failure (severely affected)
-Asymptomatic (mildly affected)
====Physical Exam====
-Systolic ejection murmur over pulmonary artery in the left heart base
-Usually normal femoral pulses
-Signs of right sided congestive heart failure may be present:
*ascites
*jugular distension & jugular pulses
====Radiographic Findings====
-Right ventricular enlargement (DV view seen at 1 o'clock)
-Right atrial enlargement
-Pulmonary artery enlargement (DV view seen at 2 o'clock)
(Changes are seen the most clearly on a dorsoventral view)
====Echocardiographic Findings====
-Right ventricular hypertrophy
-Poststenotic dilation of the pulmonary artery
-Abnormal pulmonic valve if the stenotic area is valvular
Doppler can be used to measure the pressure in the stenotic area and visualize abnormal flow
====Electrocardiographic (ECG)====
-Right ventricular hypertrophy (deep S waves, right axis deviation)
===Treatment===
Mild/Moderate Cases
-If there are no signs, no treatment is needed
Severe Cases
-Animals that exhibit many of the clinical signs will need further treatment
*Balloon valvuloplasty (done if pulmonic leaflets are fused)
*Surgical repair (done when more complex lesions & obstructions are present): valvulotomy, pericardial patch graft
===Prognosis===
Mild/Moderate Cases
-Good prognosis
Severe Cases
-Guarded prognosis