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Veterinary Cardiology - Aortic stenosis in dogs
MV Rafael Bökenhans

Heart disease in dogs - Heart

aortic stenosis in dogs is due to narrowing outflow of the left ventricle. May occur at the subvalvular (most common), valvular level, or above the valves. It has been demonstrated in hereditary breeds Boxer, Newfoundland, Golden Retriever, German Shepherd. In our experience the incidence is higher in Boxer and Rottweiler.

obstruction to the flow causes a pressure overload to the left ventricle to hypertrophy. The turbulent flow generates the systolic murmur and poststenotic dilatation of the aorta. Increased wall stress affects the coronary circulation and increased myocardial oxygen demand generated areas of ischemia, arrhythmias, and risk syncope or sudden death.

main signs in dogs with aortic stenosis are exercise intolerance, syncope and sudden death. However, often the patient is asymptomatic and the breath is detected in a routine clinical examination. It is of fundamental importance often listening to puppies and young animals of breeds predisposed, because the murmur may increase in intensity as the animal grows.

is because it is concentric hypertrophy and septal thickening may increase the degree of subaortic obstruction.

The breath that occurs is stroke, with the point of maximum intensity in the aortic area (4 th space left intercostal), with skull-dorsal spread, is heard at the entrance of the chest, for transmission to the carotid arteries, or vertebral column.

arterial pulse amplitude can be decreased.


complementary methods for the diagnosis of aortic stenosis in dogs

The chest radiograph is usually normal or show aortic dilatation and the left ventricle.

The electrocardiogram may be normal or show signs of left ventricular hypertrophy and arrhythmias (premature ventricular beats).

Echocardiography is the most sensitive method for the evaluation of this pathology and to visualize the outflow tract and possible secondary changes (concentric hypertrophy, hypertrophy of the papillary muscles)

is ideal to assess the patient with Doppler echocardiography to determine blood flow velocity and calculate the pressure gradient. In this way we can estimate the severity of the stenosis.


Treatment of aortic stenosis in dogs:

Treatment is primarily medical, exercise restriction, diuretics and drugs that reduce contractility, wall stress, oxygen demand, adrenergic blockers (propranolol, atenolol) and blockers calcium channel blockers (diltiazem), and to facilitate diastolic myocardial relaxation and decrease heart rate.

digital should not be used as contractile function is intact.


Surgical techniques to reduce the obstruction.

The prognosis is related to the degree of stenosis. In mild cases may be favorable, but there is always the risk of sudden death. The complications that can arise are: secondary mitral regurgitation and eventually left atrial dilation atrial fibrillation, congestive heart failure, bacterial endocarditis, aortic insufficiency, sudden death.