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Fig 1. (a) Two-dimensional echocardiographic image of the left atrium (LA), mitral valve, and dorsal left ventricular cavity (LV) obtained
from the left thorax. The left ventricular free wall (LVW) is thick and
hyperechoic. The interventricular septum (IVS) in the far field is less
echogenic owing to attenuation of echoes in the far field. (b) Twodimensional echocardiographic image at the cardiac base showing portions of the right atrium (RA), the aortic root (AO), and the main
pulmonary artery (PA) and right branch (RPA). The PA is dilated
(arrow) relative to the aorta, a finding compatible with pulmonary
hypertension.
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Fig 2. M-mode echocardiogram recorded across the ventricles. Structures observed from near to far field are the right ventricular free wall
(RVW), right ventricle (RV), interventricular septum (IVS), left ventricle (LV), and left ventricular wall (LVW). Global LV systolic function is
mildly reduced. The IVS and LVW are thickened. The IVS also appears hyperechoic (relative to the RVW). The LVW in the far field is less
echogenic owing to attenuation of echoes in the far field. The right ventricle contained spontaneous echocontrast. (Reference lines indicate 5 cm
depth and 0.5 seconds duration.)
Fig 3. Hematoxylin and eosinstained myocardial tissue from the interventricular septum viewed at a power of 403. Large arrowheads indicate
hyalinization around individual cardiac myocytes. Small arrowheads indicate hyalinization around blood vessels and capillaries. The apparent
areas of hyalinization are amyloid deposits, as demonstrated after viewing Congo redstained sections under polarized light (not shown).
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Fig 4. Thioflavin-Tstained myocardial tissue under ultraviolet light, demonstrating the fluorescence of amyloid deposits around individual
cardiac myocytes.
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loss of atrial filling function would have made this evaluation difficult. The most important differential diagnoses in
human medicine are RCM that is due to pericarditis and
hypertrophic cardiomyopathy. The diagnosis is made accurately in the majority of cases using current diagnostic
modalities, including Doppler echocardiography, computed
tomography, and the antemortem utilization of biopsy techniques.30,31
This report describes a case of heart failure from infiltrative cardiomyopathy caused by amyloidosis, which has
thus far not been reported in the horse. Careful echocardiography is indicated in horses with cardiac failure to determine the cause of the disease, although prognosis remains poor. The etiology of the amyloidosis in this horse
remains unknown.
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