Pulmonic Stenosis

Pulmonic Stenosis (PS) is an abnormal narrowing of the right ventricular outflow tract or stricture of the pulmonary, or lung artery. This abnormality leads to the enlargement of the right ventricle of the heart and the increase of the heart blood pressure. The right ventricle is a chamber of the heart which receives blood from a corresponding atrium and from which blood is forced into the arteries. Some cases of pulmonic stenosis result from simple fusion of the valve cusps.²

Breeds at Risk

The condition occurs mainly in the English Bulldog, Mastiff, Samoyed, Miniature Schnauzer, West Highland White Terrier, Cocker Spaniel, Beagle, Airedale Terrier, Boykin Spaniel, Fox Terrier, Boxer, Chihuahua, and Scottish Terrier.²

Signs & Treatment

Dogs with pulmonic stenosis may not show clinical signs for many months or years. The main finding on physical examination is a heart murmur heard at the left heart base. Diagnosis of pulmonic stenosis can be confirmed by echocardiography or cardiac catheterization.¹

Signs in severely affected dogs include exercise intolerance, slow growth, labored breathing, accumulation of fluid in the abdomen, a bluish or purplish discoloration of the skin due to lack of oxygenation of the blood, weakness, fainting, collapsing, and sudden death. Health checks usually reveals heart murmur. The blood test may reveal an abnormal increase in the number of circulating red blood cells (polycythemia). Some dogs may have no clinical signs of the disease. The disease is usually detected during evaluation after a previously detected heart murmur.

Treatment involves surgical correction of the stenosis using valvuloplasty procedure involving a heart valve. An alternative to surgery, balloon valvuloplasty is performed to decrease pressure in the heart, but it has limitations and . It is most effective for simple valvular pulmonic stenosis that is not associated with extensive hypertrophy of the right ventricle. Usually balloon valvuloplasty is attempted before surgical procedures because it is thought to be less risky. The procedure is performed at most cardiology referral centers.^{1, 2}

The prognosis in dogs with PS depends on the severity of the stenosis. Animals with milkd pulmonary stenosis may have a normal life span, but those with severe stenosis often die within 3 years of diagnosis.²

References

1. Douglas H. Slatter. Textbook of small animal surgery.
2. Richard W. Nelson, C. Guillermo Couto. Small Animal Internal Medicine.

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