Veterinary Clinical Medicine-I (General and Systemic)

CONGENITAL HEART DISEASES

• Congenital heart disease occur in rare frequency in dogs. While all forms are occurring in dogs, the most common defects are valve malformations (called dysplasias),valve narrowing (stenosis),abnormal openings between the heart chambers (septal defects), patent ductus arteriosus, and Tetralogy of Fallot.
• Patent ductus arteriosus is a persistent arterial connection between the aorta and pulmonary artery that normally closes at birth or shortly thereafter. In the uterus, the ductus plays an important role in shunting blood away from the nonfunctioning lungs. Many large and small breeds are affected by patent ductus arteriosus. This murmur can often be felt through the body wall-it feels like a washing machine churning.
• Tetralogy of Fallot is a congenital defect of the heart consisting of four abnormalities that result in insufficiently oxygenated blood pumped to the body.
• Most dogs with severe congenital heart defects die within the first year of life. Dogs with moderate defects may survive but usually exhibit exercise intolerance, fainting episodes, and stunted growth. In these individuals, heart failure can occur suddenly and unexpectedly. Dogs with mild valvular disease or small septal defects are often asymptomatic; the only indication of a congenital heart defect is a heart murmur discovered on physical examination.
• The diagnosis of congenital heart defect is based on ECG, chest X-rays and echocardiogram. An ultrasound study called Doppler echocardiography measures the velocity and direction of blood flow in the heart chambers. This information makes the diagnosis of congenital heart defects extremely accurate. You may need to be referred to a specialty clinic for this test.
• Cardiac catheterization with angiocardiography was once the “gold standard” for diagnosing congenital heart defects, but it carries a small risk and is often available only at referral veterinary hospitals. Doppler echocardiography, being accurate and noninvasive, has largely replaced cardiac catheterization for routine diagnosis.
• Treatment: Dogs with minor heart defects have a good prognosis and do not benefit from surgery. However, many dogs benefit from surgery to correct more severe defects. Many of these surgeries will require referral to a large veterinary centers such as teaching veterinary hospitals.