怀疑限制性心肌病的无症状麦克道尔氏地毯蟒蛇的自发回声造影

Clement Bercker, Clémence Hurtrel, L. Schilliger
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摘要

摘要1例9岁雌性麦克道尔地毯巨蟒(Morelia spilota mcdowelli)有8个月的厌食症病史。经细胞学诊断为吻侧皮下脓肿,选择手术切除。超声引导下穿刺进行麻醉前血液工作时,观察到严重的右心房扩张和低运动,房室瓣膜增厚和不规则,心室心肌高回声灶和主观性心室低运动。右心房腔内自发回声造影(SEC)。超声心动图病变与先前在同一亚种的病例报告中描述的限制性心肌病一致,并伴有额外的并发血栓形成。先前没有在爬行动物中描述过SEC,同时存在SEC和限制性心肌病表明它可能预示血栓形成,就像哺乳动物的情况一样。手术切除吻侧脓肿后,厌食症消失,提示无症状心脏病,尽管有严重的心脏病变。需要进一步的研究来证实爬行动物中心脏疾病的患病率,以及严重的心脏疾病是否可以在圈养的蛇中无症状。建议对无症状且无特异性体征的蛇类进行常规超声心动图检查。
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Spontaneous Echo Contrast in an Asymptomatic McDowell's Carpet Python (Morelia spilota mcdowelli) with Suspected Restrictive Cardiomyopathy
Abstract A 9-yr-old female McDowell's carpet python (Morelia spilota mcdowelli) presented with an 8-month history of anorexia. A rostral subcutaneous abscess was diagnosed by cytology and surgical excision was elected. During ultrasound-guided cardiocentesis for preanesthetic blood work, severe right atrial dilation and hypokinesis, thickened and irregular atrio-ventricular valves, ventricular myocardial hyperechoic foci, and subjective ventricular hypokinesis were observed. Spontaneous echo contrast (SEC) was observed inside the right atrial cavity. Echocardiographic lesions were consistent with restrictive cardiomyopathy previously described in a case report involving the same subspecies, with additional concurrent thrombus formation. SEC has not been previously described in reptiles, and the presence of simultaneous SEC and restrictive cardiomyopathy suggests that it might be predictive of thrombus formation, as is the case in mammals. Following surgical excision of the rostral abscess, anorexia resolved, suggesting asymptomatic cardiopathy despite severe cardiac lesions. Further studies are needed to confirm the prevalence of cardiac diseases in reptiles and whether severe cardiac disease can be asymptomatic in captive snakes. Routine echocardiography in asymptomatic snakes with nonspecific signs is encouraged.
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