River Update

He will be able to be neutered with a special anesthesia protocol.

He does have hypertrophic cardiomyopathy.
His murmur is grade IV/VI.

He will stay on the blood thinner and after he is neutered, we will add a second med. They can’t tell us how fast it will progress. The second medication will help relax the heart muscle.

The findings:

-There is moderate to severe left ventricular concentric hypertrophy of the left ventricular free wall.
-The LV wall is irregular and hyperechoic.
-There is a false tendon spanning the LV lumen from the posterior papillary muscle to the base of the interventricular septum. -There is a focal thickening at the insertion of the false tendon on the basilar IVS. -The papillary muscles appear prominent as well as hyperechoic, which may be secondary to myocardial fibrosis/ischemia.
-The left ventricular cavity size is within normal limits and the systolic function is normal.
-The left atrium is normal in size.

• The right ventricle is normal in size and function.
• The right atrium is normal in size.
  -The aortic valve is trileaflet and normal. There is elevated aortic outflow velocity (6 m/s) secondary to chordal SAM.
  -The mitral valve structure and function appear normal. -There is evidence of chordal SAM. There is mild to moderate MR.
  -The tricuspid valve appears normal.
  pulmonic valve is normal. -There is a dynamic right ventricular outflow tract obstruction at higher heart rates.