This is an echocardiogram of a 13 yr old m/n Miniature poodle with a loud and palpable heart murmur. Note the heart beating in real time, and the regurgitant jet (backward flow of blood) from the left ventricle into the left atrium, with a green color (which indicates turbulence).
This 3 yr old MN Boxer had chronic anorexia for several months. A Valley Fever test was IgG positive with a relatively high titer of 1:64. He was started on Fluconazole but he had become emaciated and presented for trouble breathing. An echocardiogram revealed amild amount of pleural effusion with a moderate amount of pericardial effusion, causing compression of all chambers. As a result, the chambers were relatively small. This effusion contained many strands of tissue extending from the parietal pericardium to the epicardium, in a striated pattern (video). All surfaces of the heart were involved. The strands of tissue between the parietal pericardium and the epicardium represent areas of inflammation, most likely a result of the Valley Fever.
This cannot be treated with medical therapy alone. Instead, it would require removing the pericardium and trying to remove the inflammatory material from on the surface of the heart. Unfortunately, manipulation of the heart surface, and any peeling of this material off of the heart, typically causes irritation to the surface of the heart, and arrhythmias then develop. If the pericardium is left on, then constriction develops. The prognosis is very poor.
This 5 yr MN cavalier king Charles was previously presented for respiratory issues that would not resolve with antibiotics. An echocardiogram revealed marked increased echogenicity and thickening of the mitral valve leaflets, with prolapse of the both leaflets into the left atrium. Both of the leaflets which were almost touching the anterior wall (video). Based on the mitral valve thickening and the increased echogenicity of the mitral valve leaflets, bacterial endocarditis is suspected as the cause. He will be treated with a 6 week long course of antibiotics.