What is Atrial Tear?
The heart is divided into four chambers. The upper chambers are called atria (atrium, singular), and the lower chambers are called ventricles. When the atrial wall is forced to expand more than it is capable, a tear may occur. This expansion is typically caused by an increase in volume and pressure to the left atria. Atrial tears are more common in small to medium sized dogs, older dogs, and is particularly prominent in the following breeds: Poodle, Dachshund, the Cocker Spaniel and Shetland Sheepdog.A tear in the heart is typically caused by an excess of pressure causing a chamber of the heart to expand excessively and split. Symptoms may include weakness, difficulty breathing, and weakened pulse. Treatment may include pericardiocentesis, medication, or surgery. The initial survival rate is low, and life expectancy is short.
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Symptoms of Atrial Tear in Dogs
A tear in the heart produces many symptoms consistent with other heart diseases. If your pet has an existing heart condition, it is possible that this could be a symptom of, or along with, an atrial tear.
- Weakness or collapse – may follow excess activity or excitement
- Difficult breathing
- Increased heart rate
- Weakened pulse
- Heart murmurs, arrhythmia, or other common signs of cardiac disease
Tears in the heart are easiest classified by the location and degree of the tear. By distinguishing these factors, possible concerns can be determined.
- Incomplete - If the tear in the atrium isn’t a complete tear, it’s possible that it will be temporarily sealed. From this, the tear will either heal or continue until it is a complete tear.
- Complete - A complete left atrial tear will likely lead to bleeding into the pericardial sac and can be life-threatening.
- Interatrial septum (a wall of tissue dividing the two uppermost atria chambers of the heart) - If the tear occurs on the dividing atrium wall, an atrial septal defect may result.
Causes of Atrial Tear in Dogs
Atrial tears are typically caused by an increase in volume or pressure to the left atria that forces it to expand more than it is capable. Some conditions that cause this are:
- Mitral valve endocardiosis - which results from the leaking of the mitral valve. The mitral valve is responsible for blood flow to and from the heart.
- Chordae tendineae rupture - which is when the chordae tendineae (strong, fibrous strings that attach to the lower chamber of the heart connecting the papillary muscles and the ventricle) rupture.
- Trauma to the chest - such as blunt force from an object or being hit by a car.
- Cardiac neoplasia - the abnormal growth of tissue in the heart. The most common cardiac neoplasia to cause tears in the atrial wall is hemangiosarcoma.
- Cardiac catheterization - the threading of a catheter to your heart in order to diagnose heart conditions or otherwise monitor health.
Diagnosis of Atrial Tear in Dogs
Diagnosis may be made through one, many, or all of the below tests, depending on your pet’s symptoms and overall health.
- Physical exam
- Laboratory tests to measure NT-proBNP and TnI levels
- Echocardiography, which uses ultrasound to learn about the action of the heart
Your veterinarian will use these tests to determine if your pet suffers from an atrial tear, as well as to rule out other possible heart problems or health issues that could be causing your pet’s symptoms.
Treatment of Atrial Tear in Dogs
Depending on the outcome of the examination and the following diagnosis, treatment may vary.
- In the event of a left atrial tear, pericardiocentesis, a process that uses a needle to remove fluid from the pericardial sac, may be used as a means of treatment, though it will be difficult.
- Your veterinarian may recommend a treatment process that aims to reduce the pressure in the left atrium. This will likely use medication combinations, such as diuretics and arterial vasodilators (used to dilate arteries).
- Surgery may be completed to remove the pressure on the left atrium, but this could be risky.
Recovery of Atrial Tear in Dogs
Recovery and management will vary depending on the course(s) of treatment your veterinarian advises. Your pet will need to be monitored closely following the treatment, specifically for respiratory rate, pulse quality, and heart rate. Blood pressure monitoring may be done if arterial vasodilators are used. Your veterinarian may want to do follow-up with echocardiography to monitor potential clotting. Close follow-up is usually recommended for 2-3 months after. There is a low survival rate for pets with atrial tears. For those who do survive, life expectancy is limited to several months, perhaps longer with close monitoring, management, and cage rest.
Cost of Atrial Tear in Dogs
The cost will vary depending on the diagnostic tests your veterinarian chooses to run. The total cost for diagnostic tests, which includes a physical exam, urinalysis, lab tests, x-rays, and echocardiography, is expected to be around $850. Treatment may include pericardiocentesis, medications, or pressure removal, coming in around $1,200. Your actual cost will vary depending on diagnosis and treatment courses, as well as pharmacy and veterinarian specifications. If surgery is required, the total estimated cost could reach $3,600, with additional supportive monthly costs ranging from $175 to $250.
Atrial Tear Questions and Advice from Veterinary Professionals
Hi, my dog Cairo was diagnosed with heart disease and He has two tears in his heart. I need some tips for a longer life expectancy. I have had dogs, cats, and fish with terminal illnesses before and with my dog who had kidney disease, she lived 1+ years longer than her prognosis. I just need some help with this guy, he is my whole world and he means everything to me please help. Keep in mind I am only 11, but I have a dog who we rescued who only has 3 legs and he is blind I also have a dog who is completely deaf and partly blind and I have lots of experience with other passed animals. Thanks for any advice!
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Can the use of an ACE Inhibitor drug such as Enalapril reduce the chances of a ruptured chordae tendineae in a 12-year old chihuahua with a heart murmur and CHF?
The use of ACE inhibitors in some cases have slightly decreased atrial pressure by a minimal amount, but not by a significant amount. The link below is for an article showing the effects of ACE inhibitors in dogs with ruptured chordae tendineae. Regards Dr Callum Turner DVM
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My 10 yr old shih tzu was just diagnosed with severe CHF d/t with two torn chordae tendinae. I am getting mixed feedback on his life expectancy. I am having a hard time researching the severity of having one vs two torn chordae tendae. Can you please help me understand the difference in severity? Thank you
The life expectancy is a difficult question to answer and isn’t a liner answer based on the number of ruptured chordae tendineae; the answer is dependent on the overall condition of the heart and his activity. It is important to ensure that Duncan isn’t excited, kept calm and is receiving medication for the congestive heart failure. Generally for this condition, life expectancy is measured in months rather than years. Regards Dr Callum Turner DVM
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