Pericardial disease

image of Pericardial disease
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Pericardial disease is common, with reports in referral institutions of 8% of cardiac cases in dogs and 6% of feline cases. Congenital, acquired primary and acquired secondary forms have been described. The most common pericardial diseases result in accumulation of pericardial fluid. In dogs, primary acquired disease is most common, where local (often inflammatory or neoplastic) processes are responsible. In cats, secondary acquired disease such as congestive heart failure (CHF) predominates. Pericardial disease can often be mistaken for other cardiac or non-cardiac disorders and diagnosis can be challenging. The following subjects are discussed: Normal pericardium; Pathophysiology; Causes; Clinical signs; Diagnostic approach; Pericardiocentesis; and Long-term treatment and prognosis.

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24.1 Gross pathological specimen from a dog with a confirmed right atrial haemangiosarcoma (arrowed). Gross pathological specimen from a dog with a confirmed heart base chemodectoma (arrowed). (Courtesy of R. Else.)
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24.2 ECG trace (lead II shown) from a dog with pericardial effusion showing low-voltage QRS complexes and electrical alternans. Paper speed 50 mm/s; gain 10 mm/mV.
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24.3 Right lateral recumbent radiographs of: a dog with idiopathic pericardial effusion before pericardiocentesis; the same dog following pericardiocentesis; a cat with PPDH; and a cat with a moderate amount of pericardial effusion due to intrapericardial lymphoma.
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24.4 Right parasternal long-axis view of a dog with idiopathic pericardial effusion and cardiac tamponade. The arrowheads demonstrate the collapse of the right atrial wall. Right parasternal short-axis view at the level of the papillary muscles of the heart of a cat with pericardial effusion due to intrapericardial lymphoma. The arrowheads mark the tumour. Right parasternal long-axis view of a cat with hypertrophic cardiomyopathy and secondary pericardial effusion. Right thoracic ultrasonogram in a dog with a thoracic mass causing a pleural and pericardial effusion.

LA = Left atrium; LV = Left ventricle; PE = Pericardial effusion; RA = Right atrium; RV = Right ventricle.

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24.5 Veterinary pericardiocentesis set. Large bowl of haemorrhagic fluid drained from a Golden Retriever with idiopathic pericardial effusion.
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24.7 Pericardial effusion from a dog with idiopathic pericardial effusion. Reactive mesothelial cells are present (arrowed), which can mimic neoplastic cells. May–Grünwald–Giemsa stain; original magnification X40. (Courtesy of E. Milne.)
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