Sick Sinus Syndrome (SSS) in a Maltese Dog Concurrent with Mitral Valve Endocardiosis (MVE)

말티즈견에서 발생한 Mitral Valve Endocardiosis (MVE)를 동반한 Sick Sinus Syndrome (SSS)에 대한 증례

  • Park Chul (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Jung Dong-in (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Kim Ha-Jung (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Kang Byeong-Teck (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Kim Ju-Won (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Lim Chae-Young (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University) ;
  • Yoo Jong-Hyun (Department of Veterinary internal medicine, College of veterinary medicine, Seoul National University) ;
  • Park Hee-Myung (Department of Veterinary internal medicine, College of veterinary medicine, Konkuk University)
  • 박철 (건국대학교 수의과대학 수의내과학교실) ;
  • 정동인 (건국대학교 수의과대학 수의내과학교실) ;
  • 김하정 (건국대학교 수의과대학 수의내과학교실) ;
  • 강병택 (건국대학교 수의과대학 수의내과학교실) ;
  • 김주원 (건국대학교 수의과대학 수의내과학교실) ;
  • 임채영 (건국대학교 수의과대학 수의내과학교실) ;
  • 유종현 (서울대학교 수의과대학 수의내과학교실) ;
  • 박희명 (건국대학교 수의과대학 수의내과학교실)
  • Published : 2005.12.01

Abstract

A 13-year old, female Maltese dog was presented due to a five-month history of episodic syncope. A diagnosis of sick sinus syndrome (SSS) with mitral valve endocardiosis (MVE) was made based on history takings, physical and cardiac examination, complete blood count (CBC), serum chemistry profiles, radiography, electrocardiography (ECG), atropine response test, hormonal assay, and echocardiography. In this case, SSS was definitely diagnosed by evaluation of ECG recording following atropine administration. Clinical signs were improved with medical management of theophylline (THEOLAN, KunWha Pharm, Seoul, Korea, 20 mg/kg, PO, BID). After 10 more month survival, the dog, died of respiratory distress and shock during the operation of abdominal mass removal in local animal hospital. Unfortunately, we were not able to perform necropsy after death due to owner's decline. This case demonstrates that theophylline can be used in management oF dog with SSS.

13년령의 암컷 말티즈견이 5개월간의 일시적인 기절현상 (syncope)을 주증상으로 내원하였다. 환축은 병력 청취 신체검사 심장검사 총혈액검사, 혈액 화학적 검사, 방사선학적 검사, 심전도 검사, 아트로핀 반응 검사 (atropine response test), 호르몬 검사, 심전도 검사 등을 통해 심장의 문제가 있는 것으로 진단되었다. 본 증례에서 심전도 검사는 아트로핀 투여에 의한 심전도 기록을 통해 sick sinus syndrome을 확진 하는데 중요한 역할을 하였다. 임상 증상은 테오필린 (THEOLANi, 근화제약, 서울, 한국, 20mg/kg, 경구 투여, 1일 2회)을 복용하면서 개선되었다. 환축은 10개월을 생존하였으나 지역 병원에서 복강의 종괴를 제거하는 수술을 받는 중 호흡곤란과 쇼크로 사망하였다. 사망 후 보호자의 반대로 부검은 이루어지지 않았다.

Keywords

References

  1. Bolton GR. Bradycardia. In: Current Veterinary Therapy VII. Philadelphia: WB Saunders. 1980: 376-381
  2. Boon JA. Acquired heart disease. In: Manual of Veterinary echocardiography, 1st ed. Baltimore: Lippincott Williams & Wilkins. 1998: 276
  3. Corcoran BM, Cobb M, Martin MW, Dukes-McEwan J, French A, Fuentes VL, Boswood A, Rhind S. Chronic pulmonary disease in West Highland white terriers. Vet Rec 1999; 144: 611-616 https://doi.org/10.1136/vr.144.22.611
  4. Goodwin JK. Holter monitoring and cardiac event recording. Vet Clin Nor Am Small Anim Pract 1998; 28: 1391-1407
  5. Hamlin RL, Smetzer DL, Breznock EM. Sinoatrial syncope in miniature Schnauzers. J Am Vet Med Assoc 1972; 161: 1022-1028
  6. Jordan JL, Mandel WJ. Disorders of sinus function. In: Cardiac Arrhythmias, 3rd ed. Baltimore: J. B. Lippincott. 1995: 245-295
  7. Kavanagh K. Sick sinus syndrome in a bull terrier. Can Vet J 2002; 43: 46-48
  8. Miller MS, Tilley LP. ECG of the month. J Am Vet Med Assoc 1984; 184: 423-425
  9. Moneva-Jordan A, Corcoran BM, French A, Dukes-McEwan J, Martin MW, Luis Fuentes V, Hitchcock LS, Bonagura JD. Sick sinus syndrome in nine West Highland white terriers. Vet Rec 2001; 148: 142-147 https://doi.org/10.1136/vr.148.5.142
  10. Saito D, Matsubara K, Yamanari H, Obayashi N, Uchida S, Maekawa K, Sato T, Mizuno K, Kobayashi H, Haraoka S. Effects of oral theophylline in sick sinus syndrome. J Am College Cardio 1993a; 21: 1199-1204 https://doi.org/10.1016/0735-1097(93)90246-W
  11. Sisson DD. Bradyarrhythmias and cardiac pacing. In: Current Veterinary Therapy X. Philadelphia : WB Saunders. 1989: 286-294
  12. Sneddon JF, Camm AJ. Sinus node disease: current concepts in diagnosis and therapy. Drugs 1992; 44: 728-737 https://doi.org/10.2165/00003495-199244050-00005
  13. Tilley LP. Sick sinus syndrome. In: Essentials of Canine and Feline Electrocardiography, 3rd ed. Philadelphia: Lea & Febiger. 1992: 184-187
  14. Tilley LP, Goodwin JK. Arrhythmias and Conduction Disturbances. In: Manual of Canine and Feline Cardiology. 3rd ed. Philadelphia: WB Saunders. 2001: 391-392
  15. Zipes DP. Specific arrhythmias: Diagnosis and treatment. In: Heart Disease: A Textbook of Cardiovascular Medicine, 4th ed. Philadelphia: WB Saunders. 1992: 677-679