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Reverse VSD

Patient Information

Age
11 Months
Species
Feline

Images

Right parasternal 4 chamber view. The right ventricle (RV) is severely hypertrophied.
Simultaneous view of the ventricular septal defect (VSD) and the obstruction within the RV.
Color Doppler image of the flow across the VSD and the RV obstruction obtained from a right parasternal short axis view. The red
Color Doppler clip of the VSD and the turbulence across the obstruction within the RV. The blue flow indicates reversal of flow

History

Where does my blood flow go? Flow to the left…..flow to the right… and some bubbles to boot.

Follow the flow of Dr. Peter Modler’s beautiful demonstration of a reverse VSD in a cat confirmed with a bubble study and color flow Doppler. Remember color flow acronym BART; Blue Away Red Toward the ultrasound transducer to follow the direction of flow in this July 2012 SonoPath case of the month.

An 11-month-old cat was referred owing to generalized weakness and exercise intolerance. A 4/6 systolic heart murmur was auscultated during the physical exam. Echocardiography revealed a VSD in combination with a double-chambered right ventricle and a R-L shunt.

DX

Bubble study confirms a R-L shunt as the bubbles cross from the RV into the LV outflow tract through the ventricular septal defect at the end of the video clip.

Comments

Special thanks to Austrian cardiology specialist Dr. Peter Modler for submitting this case. This case and lots more are present in Peter's specialty folder of echocardiology for your enjoyment.

Videos

Simultaneous view of the VSD and the intraventricular obstruction obtained from the right parasternum.
A muscular obstruction within the RV can be seen very clearly created by the double chambered right ventricle.
Color Doppler clip of the VSD and the turbulence across the obstruction within the RV.
Bubble study confirms a R-L shunt as the bubbles cross from the RV into the LV outflow tract through the ventricular septal defect at the end of the video clip.