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Papillary Muscle Hypertrophy

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  • Dee Dalton
    Hello. It s been some time since I was active on this list but in the past three weeks all four of my Maine Coon boys were echoed (two for the first time).
    Message 1 of 4 , Jan 31, 2005
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      Hello.

      It's been some time since I was active on this list but in the past three
      weeks all four of my Maine Coon boys were echoed (two for the first time).
      Sundance and Ricochet (both turning three years old shortly) were diagnosed
      with prominent LV papillary muscles (hypertrophy). The cardiologist
      indicated that these structures are about 50% larger than normal. Sundance
      also had trivial tricuspid regurgitation and Ricochet showed "possible
      restrictive physiology based on transmitral."

      My youngest (Sinbad) who's almost two years old was diagnosed with mild
      aortic regurgitation with thickened aortic valve leaflets. Vet checked
      Doppler BP to rule out hypertension (110 mmHg) and checked Sinbad's temp,
      which was normal, in an effort to help rule out infective endocarditis.
      Sinbad's echo was Friday (1/28). We are going to my local vet today to do
      CBC and chemistry and perhaps urinalysis to completely (I hope) rule out
      infective endocarditis. The cardiologist said that if these tests indicate
      an infection, then we'll need to do blood cultures (which are not always
      conclusive). The vet said the aortic valve problem could also be a
      congenital condition or displasia.

      My fourth boy (turning 12 in July) has mild/moderate HCM (diagnosed 3/04)
      and his follow-up echo showed no changes (the only good news I've had
      lately).

      My questions to the list are:

      1) Has anyone had experience with prominent papillary muscles (without other
      LV abnormalities). Basically I'm wondering if this hypertrophy is always an
      early sign of HCM. Last night, I read some info from a MC breeder's website
      indicating that she had two young cats with this condition who did not go on
      to develop HCM. Just want to get other opinions/experiences if possible.

      2) After reading some case studies, I am more concerned about the aortic
      regurgitation than the papillary muscle hypertrophy. Can anyone give me
      insight into this problem from personal experience?

      I will appreciate any and all comments. Thank you.

      Dee Dalton


      [Non-text portions of this message have been removed]
    • Susan
      Dee, I don t know the answers to your questions and I am at work so I don t have time to look it up, but my favorite site for information is VetGo Cardiology
      Message 2 of 4 , Jan 31, 2005
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        Dee,

        I don't know the answers to your questions and I am at
        work so I don't have time to look it up, but my
        favorite site for information is VetGo Cardiology
        Concepts because it has a Q&A format and is
        searchable.

        http://www.vetgo.com/cardio/concepts/concindx.php

        Susan


        --- Dee Dalton <dee.dalton@...> wrote:
        > My questions to the list are:
        >
        > 1) Has anyone had experience with prominent
        > papillary muscles (without other
        > LV abnormalities). Basically I'm wondering if this
        > hypertrophy is always an
        > early sign of HCM. Last night, I read some info
        > from a MC breeder's website
        > indicating that she had two young cats with this
        > condition who did not go on
        > to develop HCM. Just want to get other
        > opinions/experiences if possible.
        >
        > 2) After reading some case studies, I am more
        > concerned about the aortic
        > regurgitation than the papillary muscle hypertrophy.
        > Can anyone give me
        > insight into this problem from personal experience?
        >
        > I will appreciate any and all comments. Thank you.
        >
        > Dee Dalton




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      • jen
        Dee, Sorry to hear about your kids - wow four - I thought one was a lot of work! Deagan just had his recheck echo, and most of his hypertrophy is in his
        Message 3 of 4 , Feb 2 1:53 PM
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          Dee,

          Sorry to hear about your kids - wow four - I thought one was a lot of
          work!

          Deagan just had his recheck echo, and most of his hypertrophy is in
          his papillary muscles. He also has some mild free wall thickening
          and some thickening at the bottom of his septum, but his papillary
          muscles are far more enlarged than any other part of his heart.
          Perhaps they progress more quickly in some kitties? What did the
          cardiologist recommend?

          The aortic regurg. is rather interesting. Did they find any other
          structural problems with the left ventricle or outflow tract? Any
          stenosis in the aorta itself? Do you have the results of his other
          tests back yet?

          hugs to your guys and keep us updated,

          jen, deagan and kira the dog
        • Dee Dalton
          Jen, thank you so much for your message. Sorry for the late reply. I hope you won t mind answering some questions... When was Deagan s first echo that found
          Message 4 of 4 , Feb 5 11:29 AM
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            Jen, thank you so much for your message. Sorry for the late reply. I hope
            you won't mind answering some questions...

            When was Deagan's first echo that found the hypertrophied papillary muscles?
            Did the cardiologist say to what extent they were enlarged? Did he say how
            much the papillaries had changed since the first echo? How long from the
            first echo to the recheck? Was the LVFW and the IVS thickening new on the
            second echo? How old is Deagan and what breed is he? Is he taking any
            meds? Since this is my first experience with papillary muscle enlargement,
            I'm trying to learn whatever I can (whether it pertains to my boys or not).


            To answer your questions. My cardiologist did not recommend any medications
            for any of my boys, just a recheck in six months. For little Sinbad with
            the aortic regurgitation, the cardiologist did not find anything else wrong
            (except for the murmur). I specifically asked him about stenosis and
            pressure coming through the aortic valve because I had just been reading
            about that while I was waiting (before the echoes). He said there was no
            stenosis and he then measured the pressure at that valve and said it was
            normal. After the exam they did a Doppler BP which was also normal
            (110)--this ruled out hypertension as a cause. When I got home, I had my
            regular vet do a CBC and chemistry which showed a few abnormal levels:

            ALP 63.0 IU/L Range 10.0 to 42.0

            HGB 14.70 g/dL Range 8.0 to 13.0

            MCH 17.10 pg Range 13.0 to 17.0

            The big thing the cardiologist said to look for was WBC. Sinbad's was 16.7
            x 1,000/uL Range 5.5 - 20.0. My local vet said she did not see anything
            that would suggest infective endocarditis to her. She was not concerned
            about the abnormal items. If you have any insight about any of this, please
            let me know.

            Thank you again for your message and I look forward to hearing from you.
            Feel free to reply privately (dee.dalton@...). All the best to you and
            Deagan.

            Dee


            Message: 4
            Date: Wed, 02 Feb 2005 21:53:50 -0000
            From: "jen" <lundgren_jennifer@...>
            Subject: Re: Papillary Muscle Hypertrophy


            Dee,

            Sorry to hear about your kids - wow four - I thought one was a lot of
            work!

            Deagan just had his recheck echo, and most of his hypertrophy is in
            his papillary muscles. He also has some mild free wall thickening
            and some thickening at the bottom of his septum, but his papillary
            muscles are far more enlarged than any other part of his heart.
            Perhaps they progress more quickly in some kitties? What did the
            cardiologist recommend?

            The aortic regurg. is rather interesting. Did they find any other
            structural problems with the left ventricle or outflow tract? Any
            stenosis in the aorta itself? Do you have the results of his other
            tests back yet?

            hugs to your guys and keep us updated,

            jen, deagan and kira the dog




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