TY - JOUR
T1 - Pulmonary hypertension and right-sided heart failure in an adult llama with hepatic disease
AU - Middleton, John R.
AU - Chigerwe, Munashe
AU - Fine, Deborah M.
AU - Turk, James R.
AU - Lattimer, Jimmy C.
PY - 2006/3/1
Y1 - 2006/3/1
N2 - Case Description - A 13-year-old llama was examined because of lethargy, inappetence, and syncope. Clinical Findings - Physical examination revealed muffled heart and lung sounds and peripheral edema. Clinicopathologic abnormalities included lymphopenia, hyperglycemic, prerenal azotemia, mild hyponatremia, mild hypoalbuminemia, and high γ-glutamyltransferase and creatine kinase activities. On ultrasonography, the liver appeared hyperechoic and ascites and pleural effusion were seen. Echocardiography revealed severe dilatation of the right atrium, right ventricle, and pulmonary artery; severe tricuspid regurgitation; and high right ventricular systolic pressure consistent with right-sided heart failure secondary to pulmonary hypertension. Treatment and Outcome - Treatment with furosemide was attempted, but because of failing health, the llama was euthanized 4 weeks later. Macronodular cirrhosis of the liver, glomerulonephritis, and intimal fibrosis and medial hypertrophy of muscular pulmonary arteries were seen on histologic examination of postmortem specimens. Clinical Relevance - Findings in this case were similar to those reported for human patients with portopulmonary hypertension secondary to hepatic cirrhosis. Pulmonary hypertension secondary to hepatic disease should be considered in the differential diagnosis of right-sided heart failure.
AB - Case Description - A 13-year-old llama was examined because of lethargy, inappetence, and syncope. Clinical Findings - Physical examination revealed muffled heart and lung sounds and peripheral edema. Clinicopathologic abnormalities included lymphopenia, hyperglycemic, prerenal azotemia, mild hyponatremia, mild hypoalbuminemia, and high γ-glutamyltransferase and creatine kinase activities. On ultrasonography, the liver appeared hyperechoic and ascites and pleural effusion were seen. Echocardiography revealed severe dilatation of the right atrium, right ventricle, and pulmonary artery; severe tricuspid regurgitation; and high right ventricular systolic pressure consistent with right-sided heart failure secondary to pulmonary hypertension. Treatment and Outcome - Treatment with furosemide was attempted, but because of failing health, the llama was euthanized 4 weeks later. Macronodular cirrhosis of the liver, glomerulonephritis, and intimal fibrosis and medial hypertrophy of muscular pulmonary arteries were seen on histologic examination of postmortem specimens. Clinical Relevance - Findings in this case were similar to those reported for human patients with portopulmonary hypertension secondary to hepatic cirrhosis. Pulmonary hypertension secondary to hepatic disease should be considered in the differential diagnosis of right-sided heart failure.
UR - http://www.scopus.com/inward/record.url?scp=33644823181&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33644823181&partnerID=8YFLogxK
U2 - 10.2460/javma.228.5.756
DO - 10.2460/javma.228.5.756
M3 - Article
C2 - 16506943
AN - SCOPUS:33644823181
VL - 228
SP - 756
EP - 759
JO - Journal of the American Veterinary Medical Association
JF - Journal of the American Veterinary Medical Association
SN - 0003-1488
IS - 5
ER -