Canis ISSN: 2398-2942

Pericardial disease

Synonym(s): Pericardial effusion, pericarditis

Contributor(s): Serena Brownlie, Mark Rishniw, Jill Sammarco

Introduction

  • Cause: idiopathic or secondary to cardiac/pericardial neoplasms, right-sided heart failure, hypoproteinemia, trauma, infections.
  • Signs: acute - cardiac tamponade and collapse; chronic - right-sided backward heart failure.
  • Diagnosis: radiography, ultrasonography.
  • Treatment: depends on cause - often pericardiocentesis indicated.
  • Prognosis: depends on cause, varies from good to poor.

Pathogenesis

Etiology

  • Cardiac neoplasia, infectious agents (penetrating foreign bodies, fungal agents), idiopathic inflammatory disease, trauma, severe mitral valve disease with left atrial rupture, anticoagulant rodenticide poisoning.

Predisposing factors

General

  • Breed.

Pathophysiology

  • Pericardial disease → gradual accumulation of pericardial fluid → impaired diastolic function (compliance failure) → decreased end-diastolic volumes → poor cardiac output → sympathetic nervous system and renin-angiotensin-aldosterone system activation → tachycardia, vasoconstriction, retention of sodium and water → increased end-diastolic pressures in atria → increased ventricular filling pressures → backward heart failure → right side more susceptible (thinner walled) → increased central venous pressure (distended jugular veins, hepatic venous congestion, ascites, pleural effusion).
  • With acute pericardial effusion, compensatory mechanisms are unable to respond to the sudden decrease in cardiac output, resulting in preciptitous output failure and collapse. Acute collapse is most commonly associated with hemangiosarcomas.

Timecourse

  • Insiduous subclinical course and progressive abdominal distension with chronic disease.
  • Acute presentation: may result from hemorrhage (left atrial rupture, ruptured neoplasm, trauma).

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • de Laforcade A M, Freeman L M, Rozanski E A & Rush J E (2005) Biochemical analysis of pericardial fluid and whole blood in dogs with pericardial effusion. J Vet Intern Med 19 (6), 833-836 PubMed.
  • Heinritz C K, Gilson S D, Soderstrom M J, Robertson T A, Gorman S C, Boston R C (2005) Subtotal pericardectomy and epicardial excision for treatment of coccidioidomycosis-induced effusive-constrictive pericarditis in dogs: 17 cases (1999-2003). JAVMA 227 (3), 435-440 PubMed.
  • Mellanby R J & Herrtage M E (2005) Long-term survival of 23 dogs with pericardial effusions. Vet Rec 156 (18), 568-571 PubMed.
  • Stafford Johnson M, Martin M, Binns S & Day M J (2004) A retrospective study of clinical findings, treatment and outcome in 143 dogs with pericardial effusion. JSAP 45 (11), 546-552 PubMed.
  • Fine D M, Tobias A H & Jacob K A (2003) Use of pericardial fluid pH to distinguish between idiopathic and neoplastic effusions. J Vet Intern Med 17 (4), 525-529 PubMed.
  • Kirsch J A, Dhupa S & Cornell K K (2000) Pericardial effusion associated with metastatic disease from an unknown primary tumor in a dog. JAAHA 36(2), 121-124 PubMed.
  • Jackson J, Richter K & Launer D (1999) Thoracoscopic partial pericardectomy in 13 dogs. J Vet Intern Med 13 (6), 529-533 PubMed.
  • Bussadori C, Grasso A & Santilli R A (1998) Percutaneous pericardiotomy with balloon catheter in the treatment of malignant pericardial effusion in dogs. Radiol Med 96 (5), 503-506 PubMed.
  • Dunning D, Monnet G et al (1998) Analysis of prognostic indicators for dogs with pericardial effusion - 46 cases (1985-1996). JAVMA 212 (8), 1276-1280 PubMed.
  • Cobb M A, Boswood A, Griffin G M & McEvoy E J (1996) Percutaneous balloon pericardiotomy for the management of malignant pericardial effusion in two dogs. JSAP 37 (11), 549-551 PubMed.
  • Edwards N J (1996) The diagnostic value of pericardial fluid pH determination. JAAHA 32 (1), 63-67 PubMed.
  • Gonin-Jmaa D, Paulsen D B & Taboada J (1996) Pericardial effusion in a dog with rhabdomyosarcoma in the right ventricular wall. JSAP 37 (4), 193-196 PubMed.


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