Mitral valve prolapse and moderate insufficiency in a 10 year old FS Maltese

History

A 10 year old female spayed Maltese was presented for excessive urination. The only significant abnormality on physical examination was a grade II/VI systolic heart murmur. On urinalysis, an inappropriate SG and 2+ proteinuria was present. CBC was within normal limits, but blood chemistry showed elevated ALT activity and azotemia. T4 was 1.2.

Clinical Differential Diagnosis

Heart disease – mitral valve insufficiency, vegetative endocarditis. Renal disease – primary chronic renal failure, glomerulonephritis, pyelonephritis.

DX

Mild mitral valve prolapse. Clinically compensated moderate mitral insufficiency.

Sampling

None

Sonographic Differential Diagnosis

Mild mitral valve prolapse. Moderate mitral insufficiency. No left atrial enlargement. Clinically compensated at this time.

Image Interpretation

The cranial and caudal mitral valve leaflets demonstrated mildly vegetative contour. Slight prolapse was noted in this patient (Video 1 and 2). Mitral insufficiency velocity measured 6.3 m/sec. Color flow Doppler assessment revealed moderate left atrial filling of the mitral regurgitant jet (Video 2).